MedWorm: Bronchoscopy

Bronchoscopy in Rural Areas?

Advances in Urology — Mon, 06 Feb 2012 12:46:42 +0100

Quality of bronchoscopy performed by one single pulmonologist in a scarcely populated subarctic area was compared to the guidelines provided by the British Thoracic Society (BTS). 103 patients underwent bronchoscopy. Diagnostic yield was increased to 76.6% when the first bronchoscopy was supplemented by bronchial washing fluid and brush cytology and to 86.7% (BTS guidelines >80%) after a second bronchoscopy. Median time from referral to bronchoscopy was 10 days and 8 days from positive bronchoscopy to operative referral to another hospital. 1% of patients that underwent transbronchial lung biopsy had minor complications. One pulmonologist had rate of correct diagnosis based on visible endobronchial tumors that was comparable to the rates of numerous pulmonologists at larger center...

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Lung Separation in the Morbidly Obese Patient

Advances in Urology — Mon, 06 Feb 2012 12:46:42 +0100

Lung separation techniques in the morbidly obese patient undergoing thoracic or esophageal surgery may be at risk of complications during airway management. Access to the airway in the obese patient can be a challenge because they have altered airway anatomy, including a short and redundant neck, limited neck extension and accumulation of fat deposition in the pharyngeal wall contributing to difficult laryngoscopy. Securing the airway is the first priority in these patients followed by appropriate techniques for lung separation with the use of a single-lumen endotracheal tube and a bronchial blocker or another alternative is with the use of a double-lumen endotracheal tube. This review is focused on the use of lung isolation devices in the obese patient. The recommendations are based upon ...

[Correspondence] McCoy's syndrome: a new medical entity

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

A 40-year-old woman was sent to our service for a bronchoscopy owing to multiple interstitial pulmonary infiltrates. She complained of a dry cough, dyspnoea, and wheezing of 4 months' duration. She also reported bronchospasm episodes in childhood. The patient had already been seen by three different clinicians and brought with her several test results, including a thorax CT. She had been treated with antibiotics, bronchodilators, and steroids, without improvement. (Source: LANCET)

Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis

Advances in Pharmacological Sciences — Thu, 02 Feb 2012 18:35:24 +0100

We describe the anesthetic management of a patient with severe myasthenia gravis and tracheal stenosis; the patient was scheduled for direct laryngoscopy and dilatation. The combination of myasthenia gravis and tracheal obstruction presents several difficulties for anesthetic management. The airway is shared; therefore, any complications are also shared by the anesthesiologist and bronchoscopists. The potential for respiratory compromise in patients undergoing the two procedures requires that anesthesiologists be familiar with the underlying disease state, as well as the interaction of anesthetic and nonanesthetic drugs in a case involving myasthenia gravis. We reviewed the literature and report our experience in this case. There is no strong evidence for choosing one approach to general a...

Endotracheal metastasis from basaloid squamous carcinoma of the esophagus

Esophagus — Thu, 02 Feb 2012 18:15:46 +0100

We describe a rare case of metachronous endotracheal metastasis originating from esophageal basaloid squamous carcinoma. A 72-year-old Japanese man underwent esophagectomy for stage I esophageal cancer. Pathological diagnosis of the resected specimen was basaloid squamous carcinoma. One year later, a follow-up computed tomography scan displayed a tumor shadow in the tracheal wall. Bronchoscopy revealed a protruding tumor in the tracheal wall, and the pathologic diagnosis of the biopsy specimen was also basaloid squamous carcinoma. According to the diagnosis of metachronous endobronchial metastasis from esophageal basaloid squamous carcinoma, we treated the patient with chemotherapy comprising docetaxel, cisplatin, and 5-fluorouracil followed by chemoradiotherapy, and complete respons...

Lipid-Laden Alveolar Macrophages and pH Monitoring in Gastroesophageal Reflux-Related Respiratory Symptoms

Clinical and Developmental Immunology — Thu, 02 Feb 2012 11:21:45 +0100

This study was conducted to prove a correlation between the detection of alimentary pulmonary fat phagocytosis and an increasing amount of proximal gastroesophageal reflux. It was assumed that proximal gastroesophageal reflux better correlates with aspiration than distal GER. Patients from 6 months to 16 years with unexplained recurrent wheezy bronchitis and bronchial hyperreactivity, or recurrent pneumonia with chronic cough underwent 24-hour double-channel pH monitoring and bronchoscopy with bronchoalveolar lavage (BAL). Aspiration of gastric content was determined by counting lipid laden alveolar macrophages from BAL specimens. There were no correlations between any pH-monitoring parameters and counts of lipid-laden macrophages in the whole study population, even when restricting analys...

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Bronchoscopic Findings in Children With Chronic Wet Cough

PEDIATRICS — Wed, 01 Feb 2012 05:00:00 +0100

Chronic wet cough is a common symptom well recognized by pediatricians. Protracted bacterial bronchitis is defined as more than 4 weeks of wet cough that responds to antibiotic treatment. Diagnosis of protracted bacterial bronchitis is not readily accepted by pediatricians Children with chronic wet cough often have bronchitis, which is evident during bronchoscopy. Purulent bronchial secretions suggest the presence of bacterial infection. Children with chronic wet cough frequently have a bacterial infection of the lower airway. (Read the full article) (Source: PEDIATRICS)

Leiomyoma of the trachea.

The Annals of Thoracic Surgery — Tue, 31 Jan 2012 04:17:06 +0100

We report a case of an incidental tracheal leiomyoma diagnosed and treated with a combined approach. PMID: 22269742 [PubMed - in process] (Source: The Annals of Thoracic Surgery)

Perioperative considerations in patients with Gitelman syndrome: a case series

Journal of Clinical Anesthesia — Sun, 29 Jan 2012 12:15:49 +0100

Conclusion: Gitelman syndrome is a mild disorder when appropriately managed. (Source: Journal of Clinical Anesthesia)

Ergonomics in bronchoscopy: is there a need for better design or a change in the work environment?

Expert Review of Respiratory Medicine — Sat, 28 Jan 2012 04:02:41 +0100

Expert Review of Respiratory Medicine , February 2012, Vol. 6, No. 1, Pages 1-2. (Source: Expert Review of Respiratory Medicine)

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Role of YKL-40 in Bronchial Smooth Muscle Remodeling in Asthma.

American Journal of Respiratory and Critical Care Medicine — Thu, 26 Jan 2012 05:00:00 +0100

CONCLUSION: This study indicates that YKL-40 promotes BSM cell proliferation and migration through a PAR-2-dependent mechanism. PMID: 22281830 [PubMed - as supplied by publisher] (Source: American Journal of Respiratory and Critical Care Medicine)

Does the use of extended criteria donors influence early and long-term results of lung transplantation?

Interactive CardioVascular and Thoracic Surgery — Wed, 25 Jan 2012 05:00:00 +0100

A best evidence topic was constructed according to a structured protocol. The question addressed was whether the presence of extended criteria donors influences the early and long-term results in patients referred for lung transplantation. Of the 30 papers found using a report search, 14 presented the best evidence to answer the clinical question. The authors, journal, date, country of publication, study type, group studied, relevant outcomes and results of these papers are given. In total, we recorded 10 retrospective studies that considered all the donor criteria for comparing marginal donors (MDs) and standard donors. On the one hand, six of them showed no difference between the two groups in terms of early and long-term results. On the other hand, four studies demonstrated a negative i...

Intrathoracic gossypiboma causing intractable cough

Interactive CardioVascular and Thoracic Surgery — Wed, 25 Jan 2012 05:00:00 +0100

A 45-year old woman presented with a 5-month history of coughing, eight months after surgery for post-tubercular fibrosis with bronchiectasis. Upon computerized tomography (CT) scanning, a sponge-like structure was seen in the pneumonectomy cavity near the stump of the right main bronchus. Bronchoscopic examination revealed a whitish mass blocking the right main bronchial stump which, upon attempted retrieval, yielded long threads of cotton fibres from a retained surgical gauze. The gossypiboma was removed surgically and the patient became symptom-free. Although rare after thoracic surgery, gossypibomas need to be considered in symptoms following surgery. (Source: Interactive CardioVascular and Thoracic Surgery)

Leiomyoma of the Trachea [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 24 Jan 2012 05:00:00 +0100

We report a case of an incidental tracheal leiomyoma diagnosed and treated with a combined approach. (Source: The Annals of Thoracic Surgery)

A National Survey of Airway Management Training in U.S. Internal Medicine-Based Critical Care Fellowship Programs.

Respiratory Care — Mon, 23 Jan 2012 05:00:00 +0100

CONCLUSION: The majority of programs have a formal airway management program incorporating a variety of intubation techniques. Overall experience varies widely, however. PMID: 22273367 [PubMed - as supplied by publisher] (Source: Respiratory Care)

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Electromagnetic Navigation Bronchoscopy Performed by Thoracic Surgeons: One Center's Early Success.

The Annals of Thoracic Surgery — Mon, 23 Jan 2012 05:00:00 +0100

CONCLUSIONS: It is possible for thoracic surgeons to perform ENB with early success. The high diagnostic yields in this study may be attributed to the routine utilization of ROSE and general anesthesia, which preserves computed tomographic-to-body divergence. PMID: 22277964 [PubMed - as supplied by publisher] (Source: The Annals of Thoracic Surgery)

Presentation of laryngeal papilloma in childhood: the Leeds experience

International Journal of Clinical Practice — Sat, 21 Jan 2012 13:59:51 +0100

Conclusion: The take home message for clinicians is hoarse voice associated with shortness of breath needs specialist referral. (Source: International Journal of Clinical Practice)

Lung adenocarcinoma with peculiar growth to the pulmonary artery and thrombus formation: Report of a case

World Journal of Surgical Oncology — Sat, 21 Jan 2012 05:00:00 +0100

Conclusions: This is the first reported case of radical resection of a lung cancer with invasion along the pulmonary artery wherein a benign thrombus had formed. In general, surgery would be the treatment of choice for a pulmonary artery mass. (Source: World Journal of Surgical Oncology)

Should bronchoscopy be advocated to study airway remodelling and inflammation in adults with cystic fibrosis?

Thorax — Fri, 20 Jan 2012 05:00:00 +0100

We read with interest the article by Regamey et al who reviewed the relationship of airway remodelling to inflammation in cystic fibrosis (CF).1 The authors suggested that endobronchial biopsy studies are useful for studying airway remodelling in CF. Four studies were conducted in 91 children who underwent bronchoscopy for clinical reasons or annual routine surveillance. These studies confirmed that airway remodelling in CF appeared early in life and this is indeed of more than academic interest. However, while the authors have previously shown and claimed that biopsy procedures are safe in infants and small children, the ethics of the procedure in children have been discussed by others.2 We would like to raise concerns about the procedure in adults as well. From 1987 to 2011, Regamey et a...

Authors' response

Thorax — Fri, 20 Jan 2012 05:00:00 +0100

We thank Burgel and colleagues for their valuable comments.1 We agree that a cautious approach should be adopted when considering the use of bronchoscopy and biopsy in cystic fibrosis (CF) research. As stated in our review article,2 we have confirmed the safety of endobronchial biopsy in children and infants with CF. Reassuringly, we have encountered no complications even in children with advanced lung disease. We advocate the use of endobronchial biopsy to investigate mechanisms of airway remodelling events and their relationship to infection and inflammation in children, but claim no experience of bronchoscopy in adult CF. It would be inappropriate for us to comment on the role of bronchoscopy in adults. Competing interestsNone. ContributorsAll authors contributed to this letter equally...

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The management of bronchus intermedius complications after lung transplantation: A retrospective study

Journal of Cardiothoracic Surgery — Fri, 20 Jan 2012 05:00:00 +0100

Conclusion: BI complications after lung transplantation are still a significant problem. Stenosis or malacia following lung transplantation could be well managed with modified Montgomery T-tube. (Source: Journal of Cardiothoracic Surgery)

Protandim(R) does not influence alveolar epithelial permeability or intrapulmonary oxidative stress in human subjects with alcohol use disorders.

American Journal of Physiology. Lung Cellular and Molecular Physiology — Fri, 20 Jan 2012 05:00:00 +0100

Authors: Burnham EL, McCord JM, Bose S, Brown LA, House R, Moss M, Gaydos J Abstract Alcohol use disorders (AUDs), including alcohol abuse and dependence, have been linked to the development of acute lung injury (ALI). Prior clinical investigations suggested an association between AUDs and abnormal alveolar epithelial permeability mediated through pulmonary oxidative stress that may partially explain this relationship. We sought to determine if correcting pulmonary oxidative stress in the setting of AUDs would normalize alveolar epithelial permeability in a double-blinded, randomized, placebo-controlled trial of Protandim, a nutraceutical reported to enhance antioxidant activity. We randomized 30 otherwise healthy AUD subjects to receive directly observed inpatient oral therapy wit...

CT Screening for Lung Cancer: Implication of Lung Biopsy Recommendations

American Journal of Roentgenology — Thu, 19 Jan 2012 05:00:00 +0100

OBJECTIVE. The purpose of this article is to address the implications of invasive diagnostic procedures recommended by a lung cancer screening protocol. In particular, we assess how many invasive procedures were recommended for benign nodules. MATERIALS AND METhODS. Between 2003 and 2009, 4782 high-risk current and former smokers were enrolled in a lung cancer screening study. A helical low-dose CT of the chest was performed. Morphologic features targeted were parenchymal nodules. The indication for biopsy was made according to the diagnostic algorithm provided by the International Early Lung Cancer Action Program. We recorded the time points of biopsy recommendation; shape, size, and growth of nodules; types of diagnostic procedures; complication rates; and final pathologic diagnosis. RES...

Hiccups Induced by Midazolam During Sedation in Flexible Bronchoscopy.

Archivos de Bronconeumologia — Thu, 19 Jan 2012 05:00:00 +0100

Authors: Arroyo-Cózar M, Grau Delgado J, Gabaldón Conejos T PMID: 22265321 [PubMed - as supplied by publisher] (Source: Archivos de Bronconeumologia)

Fiber-optic bronchoscope and detection of lung cancer: A five year study.

Neoplasma — Thu, 19 Jan 2012 04:30:02 +0100

Authors: Gao L, Asmitanand T, Ren H, Wu F, Zhang Y, Li X, DI L, Song Z, Yang T, Chen T, Merrilees M, Wu L, Chen M Abstract White light bronchoscopy [WLB] has been used for identification and localization of intra-epithelial pre-neoplastic and neoplastic lesions within the bronchus. Aim of the study was to evaluate the uses of WLB to detect and localize the precancerous and cancerous lesions, and in addition to analyze morphologic presentation, and association to histological type and the variation between genders.A total of 4983 patients were examined by WLB from 2004 to 2009 in a local tertiary teaching hospital. The following parameters were collected: morphological presentation, biopsy sites, histology. The patients' records of age, sex, smoking status, blood-gas, X-RAY/CT, CB...

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A Case of Endobronchial Aspergilloma Presenting as a Broncholith.

The American Journal of the Medical Sciences — Wed, 18 Jan 2012 05:00:00 +0100

Authors: Yeo CD, Baeg MK, Kim JW Abstract A 75-year-old woman with no history of pulmonary disease was admitted to the hospital complaining of fever and chills. Chest computed tomography and bronchoscopy suggested a broncholith-like calcified endobronchial lesion and postobstructive pneumopathy in the left lower bronchus. The mass obstructing the airway was removed using grasping forceps and it was diagnosed pathologically as endobronchial aspergillosis. Endobronchial aspergilloma presenting radiographically as a calcification without adjacent calcified lymph nodes is a rare condition, even though pulmonary fungal diseases including endobronchial actinomycosis can mimic broncholithiasis. PMID: 22261627 [PubMed - as supplied by publisher] (Source: The American Journal of the Med...

Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body

International Journal of Pediatric Otorhinolaryngology — Tue, 17 Jan 2012 21:16:09 +0100

Conclusions: Basing the decision to perform RB solely on the clinical findings and chest radiography entails a 25% rate or more of negative exams. CT scan appears to be the most accurate non-invasive tool for ruling out the presence of a FB but its use cannot be systematic due to its complexity and the risks of exposure to radiation. Digital substraction fluoroscopy is a safe and simple mean to confirm the presence of air trapping generated by a bronchial obstruction, but it is not sensitive enough to definitively rule out a FB. We propose a stepwise approach using fluoroscopy or possibly flexible bronchoscopy under sedation, in order to reduce the number of negative RBs while restricting the use of the CT scan. (Source: International Journal of Pediatric Otorhinolaryngology)

Evaluation of pediatric subglottic cysts

International Journal of Pediatric Otorhinolaryngology — Tue, 17 Jan 2012 21:16:09 +0100

Conclusion: Diagnostic laryngoscopy and bronchoscopy are important in diagnosing SGC. History of premature birth and intubation are not ‘sine qua non’ of SGC as SGC may be congenital as well. Symptoms of SGCs may mimic the characteristic features of chronic obstructive lung disease, so evaluation of the airway should be considered in such infants if they have stridor or hoarseness not responding to routine treatment. Laryngoscopy and bronchoscopy are routinely indicated for airway evaluation in at-risk infants. (Source: International Journal of Pediatric Otorhinolaryngology)

Year in review 2011: Respiratory infections, tuberculosis, pleural diseases, bronchoscopic intervention and imaging

Respirology — Mon, 16 Jan 2012 05:00:00 +0100

(Source: Respirology)

Accuracy of Histological Classification of Needle Biopsy/Aspirate Specimens in Patients With Non-Small Cell Lung Cancer (NSCLC)

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:22 +0100

Conclusions: Histological subclassification is important to guide therapy in NSCLC. Even in a tertiary referral cancer center, the rate of inaccuracy of histological subclassification based on limited biopsy material is significant, especially when neoadjuvant therapy is used. Clinicians managing patients with NSCLC need to recognize this discordance. Further research is needed to develop new biomarkers capable of using limited biopsy material to subclassify NSCLC accurately. (Source: Journal of Surgical Research)

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Minimally invasive bronchoscopic resection of benign tumors of the bronchi

Jornal Brasileiro de Pneumologia — Sat, 14 Jan 2012 21:08:57 +0100

CONCLUSIONS: Minimally invasive bronchoscopic resection is a safe, effective method for treating selected benign tumors of the main airway and has a low complication rate. (Source: Jornal Brasileiro de Pneumologia)

Video-Assisted Thoracoscopic Lung Biopsy in the Diagnosis of Interstitial Lung Disease: A Prospective, Multi-Center Study in 224 Patients.

Archivos de Bronconeumologia — Thu, 12 Jan 2012 05:00:00 +0100

CONCLUSIONS: Anatomical location and number of lung biopsy specimens did not seem to influence the diagnosis. The patients included in an ASP had a complication rate comparable to that of the hospitalized, so this procedure can be included in a surgical outpatient program. Lung biopsy obtained by VAT is a powerful and safe tool for diagnosis of suspected ILD, resulting in a definitive diagnosis for the majority of patients with a low morbidity rate. PMID: 22244947 [PubMed - as supplied by publisher] (Source: Archivos de Bronconeumologia)

Endobronchial valve deployment in severe α‐1 antitrypsin deficiency emphysema: A case series

The Clinical Respiratory Journal — Wed, 11 Jan 2012 05:00:00 +0100

Conclusions: The data from this case series suggests this intervention may provide bridging therapy to subsequent transplantation for younger AAT patients with end stage emphysema. (Source: The Clinical Respiratory Journal)

Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study

Journal of Cardiothoracic Surgery — Tue, 10 Jan 2012 05:00:00 +0100

Conclusions: AF after pulmonary lobectomy for lung cancer, in addition to causing higher hospital morbidity and mortality, predicts poorer long-term outcome in 5-year survivors. (Source: Journal of Cardiothoracic Surgery)

Extracellular matrix in airway smooth muscle is associated with dynamics of airway function in asthma

Allergy — Mon, 09 Jan 2012 05:00:00 +0100

Conclusion:In asthma, ECM in ASM is related to the dynamics of airway function in the absence of differences in ECM expression between asthma and controls. This indicates that the ASM layer in its full composition is a major structural component in determining variable airways obstruction in asthma. (Source: Allergy)

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Web-based versus traditional lecture: are they equally effective as a flexible bronchoscopy teaching method?

Interactive CardioVascular and Thoracic Surgery — Mon, 09 Jan 2012 05:00:00 +0100

This study compares the traditional live lecture to a web-based approach in the teaching of bronchoscopy and evaluates the positive and negative aspects of both methods. We developed a web-based bronchoscopy curriculum, which integrates texts, images and animations. It was applied to first-year interns, who were later administered a multiple-choice test. Another group of eight first-year interns received the traditional teaching method and the same test. The two groups were compared using the Student's t-test. The mean scores (±SD) of students who used the website were 14.63 ± 1.41 (range 13–17). The test scores of the other group had the same range, with a mean score of 14.75 ± 1. The Student's t-test showed no difference between the test res...

Turban pin aspiration: New fashion, new syndrome

The Laryngoscope — Fri, 06 Jan 2012 05:00:00 +0100

Conclusions:Clinicians should be aware of this distinct form of foreign body aspiration, its method of diagnosis, and extraction techniques. A cultural investigation showed a difference in the turban fastening technique of young girls as compared with their mothers. Removal by rigid bronchoscopy is a safe method with high success rate and should be considered as the preferred extraction method of choice. (Source: The Laryngoscope)

Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient

The Laryngoscope — Fri, 06 Jan 2012 05:00:00 +0100

Conclusion:PDT can be performed safely in obese patients. There were no statistically significant differences in measured variables found between the two study groups. This study supports the use of Intensive Care Unit bedside PDT in the obese population. (Source: The Laryngoscope)

Surgical treatment of right middle lobe syndrome in children

Annals of Thoracic Medicine — Fri, 06 Jan 2012 05:00:00 +0100

Conclusions: Children with right middle lobe syndrome unresponsive to medical treatment should undergo early lobe resection to avoid serious complications and the progression of the disease to other segments or lobes. (Source: Annals of Thoracic Medicine)

Descriptive data on cancerous lung lesions detected by auto-fluorescence bronchoscope: A five-year study

Annals of Thoracic Medicine — Fri, 06 Jan 2012 05:00:00 +0100

Conclusion: AFB is efficient in the detection of pre-invasive and invasive lung lesions. The morphological presentation is associated to the histological type. There is variation in the presentation and histology of cancerous lung lesions between genders. (Source: Annals of Thoracic Medicine)

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Fistula Formation Between the Right and Left Main Bronchus Caused by Endobronchial Tuberculosis.

The American Journal of the Medical Sciences — Fri, 06 Jan 2012 05:00:00 +0100

Authors: Nemati A, Safavi E, Ghasemiesfe M, Anaraki MZ, Firoozbakhsh S, Khalilzadeh O, Anvari M Abstract The prevalence of endobronchial tuberculosis (EBTB) in patients with active tuberculosis is about 10% to 40%. The most common complication of EBTB is bronchial stenosis. Fistula formation by pulmonary tuberculosis is a very rare complication and is most commonly bronchopleural. The authors present a 53-year-old woman presented with chronic cough and abnormality in chest computed tomography scan. According to chest computed tomography scan finding, bronchoscopic study was done and bronchial lavage was obtained. Bronchial lavage was positive for acid fast bacilli. Bronchoscopy showed fistula formation between the right and left main bronchus, a rare manifestation of EBTB. The pati...

A Fatal Case of Kaposi Sarcoma Due to Immune Reconstitution Inflammatory Syndrome.

The American Journal of the Medical Sciences — Fri, 06 Jan 2012 05:00:00 +0100

This report describes a fatal case of IRIS-KS. A 32-year-old man with HIV/AIDS was initiated on HAART and experienced rapid immunological and virological response to therapy. He subsequently experienced progressively severe dyspnea and papulonodular skin lesions and was admitted to the hospital with hypoxic respiratory failure. Bronchoscopy revealed numerous friable endobronchial lesions. Histopathology of a skin lesion was consistent with KS. The relatively rapid progression of disease in the setting of improvement in immune function after initiating HAART suggested IRIS-KS. This report reviews previously published cases of IRIS-KS and describes risk factors, immunopathogenesis and treatment options. PMID: 22227511 [PubMed - as supplied by publisher] (Source: The American Journal of t...

Study of Efficacy of Anaesthesia With Propofol and Fentanyl for Rigid Bronchoscopy in Foreign Body Bronchus Removal in Children

Indian Journal of Otolaryngology and Head and Neck Surgery — Thu, 05 Jan 2012 17:01:27 +0100

We report a study in five children of use of a technique of spontaneous ventilation using propofol with fentanyl, midzolam and sevoflurane without the use of muscle relaxant. In our study no side effects were seen in the study group. Spontaneous ventilation using propofol, fentanyl, midzolam and sevoflurane can be safely used in children for rigid bronchoscopy for foreign body bronchus removal. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s12070-011-0476-3Authors Angshuman Dutta, Department of ENT, 5 Air Force Hospital, Jorhat, Assam, IndiaSachin Shouche, Department of Anaesthesia, Command Hospital (AF), Bangalore, India Journal Indian Journal of Otolaryngology and Head & Neck SurgeryOnline ISSN 0973-7707Print ISSN 2231-3796 (Source: Indian Jo...

Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient

International Urology and Nephrology — Wed, 04 Jan 2012 06:59:18 +0100

We report a case of pulmonary nocardiosis associated with cytomegalovirus retinitis in a renal transplant recipient, followed by chronic allograft dysfunction. Our patient was a 50-year-old male renal allograft recipient, with diabetes mellitus and hypertension, who was diagnosed with pneumonia and cytomegalovirus retinitis. High-resolution computed tomography scan of the thorax and bronchoscopy revealed nocardial pneumonia. The patient responded well to ceftriaxone and was later switched to oral minocycline. To our knowledge, this is the first report of a successful treatment of co-infection with Nocardia pneumonia and cytomegalovirus retinitis in a renal transplant patient, with early diagnosis and prompt treatment. Content Type Journal ArticleCategory Nephrology – Case Repor...

Endobronchial Ultrasound Plus Fluoroscopy Versus Fluoroscopy-Guided Bronchoscopy: A Comparison of Diagnostic Yields in Peripheral Pulmonary Lesions

Lung — Mon, 02 Jan 2012 16:47:28 +0100

Conclusions Bronchoscopy under EBUS and fluoroscopy guidance improved the diagnostic yield of PPLs, especially of those smaller than 20 mm in diameter. Content Type Journal ArticlePages 1-5DOI 10.1007/s00408-011-9359-3Authors Viboon Boonsarngsuk, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400 ThailandPensupa Raweelert, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400 ThailandSabaithip Juthakarn, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 10400 Thailand ...

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Nodal stations and diagnostic performances of endobronchial ultrasound-guided transbronchial needle aspiration in patients with non-small cell lung cancer.

J Korean Med Sci — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Jhun BW, Park HY, Jeon K, Koh WJ, Suh GY, Chung MP, Kim H, Kwon OJ, Han J, Um SW Abstract There are no accurate data on the relationship between nodal station and diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). We evaluated the impact of nodal station and size on the diagnostic performance of EBUS-TBNA in patients with non-small cell lung cancer (NSCLC). Consecutive patients who underwent EBUS-TBNA of mediastinal or hilar lymph nodes for staging or diagnosis of NSCLC were included in this retrospective study. Between May 2009 and February 2010, EBUS-TBNA was performed in 373 mediastinal and hilar lymph nodes in 151 patients. The overall diagnostic sensitivity, specificity, accuracy and negative predictive value (NPV) ...

Accuracy of electromagnetic tracking with a prototype field generator in an interventional OR setting.

Medical Physics — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: Electromagnetic (EM) tracking with the new WFG during C-arm based fluoroscopy guidance seems to be a step forward, and with a correction scheme implemented it should be feasible. PMID: 22225309 [PubMed - as supplied by publisher] (Source: Medical Physics)

EXIT (Ex utero Intrapartum Treatment) in lymphatic malformations of the head and neck: Discussion of three cases and proposal of an EXIT-TTP (Team Time Procedure) list

International Journal of Pediatric Otorhinolaryngology — Sun, 01 Jan 2012 05:00:00 +0100

Conclusions: In case of prenatal suspicion of airway obstruction, EXIT should be planned with a multidisciplinary team. The EXIT-Team Time Procedure list (EXIT-TTP list), reviews the most critical phases of the procedure when different teams are working together. The type of lymphatic malformation, the anatomic location and the clinical score predict the outcome. (Source: International Journal of Pediatric Otorhinolaryngology)

Bronchoscopic thermal vapor ablation improves emphysema

Modern Medicine — Fri, 30 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - Bronchoscopic thermal vapor ablation therapy (BTVA) improves lung function, quality of life, and exercise tolerance in patients with heterogeneous emphysema, two international trials have shown. (Source: Modern Medicine)

FDA Targets Risks From Reused Medical Devices

Health News from Medical News Today — Thu, 29 Dec 2011 09:00:00 +0100

Some medical devices are reused many times in surgical and exploratory procedures. They include instruments used in surgery (like clamps and forceps), and endoscopes (like bronchoscopes and colonoscopes) used to visualize areas inside the body. FDA has received reports of patient exposure to microscopic amounts of blood, body fluids, and tissue from other patients that may have occurred because the reusable devices were inadequately "reprocessed" and these contaminants were not removed. (Reprocessing means cleaning and high-level disinfection or sterilization... (Source: Health News from Medical News Today)

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Endobronchial Foreign Body Removed by Flexible Bronchoscopy Using the Trendelenburg Position

The Thoracic and Cardiovascular Surgeon — Thu, 29 Dec 2011 05:00:00 +0100

We report FB aspiration in an old male patient in whom attempted removal with flexible bronchoscopy failed but was later achieved by repeated flexible bronchoscopy with the patient in the trendelenburg position.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents | Abstract | Full text (Source: The Thoracic and Cardiovascular Surgeon)

Prospective Randomised Trial of Ebus Guide Sheath Versus CT Guided Percutaneous Core Biopsies for Peripheral Lung Lesions

Internal Medicine Journal — Thu, 29 Dec 2011 05:00:00 +0100

Conclusions: In lesions <2cm, CT‐guided biopsy had higher yields however EBUS GS had better tolerability and fewer complications. (Source: Internal Medicine Journal)

Endobronchial Foreign Body Removed by Flexible Bronchoscopy Using the Trendelenburg Position.

The Thoracic and Cardiovascular Surgeon — Thu, 29 Dec 2011 05:00:00 +0100

We report FB aspiration in an old male patient in whom attempted removal with flexible bronchoscopy failed but was later achieved by repeated flexible bronchoscopy with the patient in the trendelenburg position. PMID: 22207366 [PubMed - as supplied by publisher] (Source: The Thoracic and Cardiovascular Surgeon)

Deaths and complications associated with respiratory endoscopy: A survey by the Japan Society for Respiratory Endoscopy in 2010

Respirology — Wed, 28 Dec 2011 05:00:00 +0100

Conclusions: Respiratory endoscopy was performed safely, but education regarding complications caused by new techniques is necessary. (Source: Respirology)

Implantable coils improve COPD in pilot study

Modern Medicine — Tue, 27 Dec 2011 05:00:00 +0100

NEW YORK (Reuters Health) - Chronic obstructive pulmonary disease (COPD) due to heterogeneous emphysema improved significantly in a pilot study when lung volume reduction (LVR) coils were placed via bronchoscopy. (Source: Modern Medicine)

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Initial results of the National Lung Cancer Screening Trial.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: McLoud TC Abstract The findings from the National Cancer Institute's National Lung Cancer Screening Trial (NLST) were recently published in the New England Journal of Medicine. The trial demonstrated that lung cancer mortality can be reduced by annual screening with low-dose computed tomography (CT). It is possible that widespread lung screening in high-risk groups can save many lives. Screening is associated not only with benefits but also possible harms. A number of observational single arm lung cancer screening trials with CT were carried out in the 1990s and during the past decade. These demonstrated that low-dose CT could identify cancers at early treatable stages and that survival was prolonged. The NLST was launched in 2002 and it is the first randomized controlled ...

Lung cancer screening: rationale and background.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Authors: Diederich S Abstract The poor outcome in symptomatic lung cancer patients and the much better prognosis when lung cancer is diagnosed and treated at early asymptomatic stages call for screening. As lung cancer predominantly affects smokers and individuals exposed to other carcinogens, screening programs need not include the whole population but only these risk groups. Every screening program will tend to better identify the more indolent tumours that grow slowly enough to be detected by screening before symptoms develop, whereas aggressive fast-growing tumours may present as interval cancers despite screening (length-time bias). Some malignant tumours detected with screening may never cause the person's death due to competing causes for death, particularly in heavy smokers...

Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools

Journal of Allergy and Clinical Immunology — Mon, 26 Dec 2011 05:00:00 +0100

Conclusion: Intense, long-term swimming training in indoor chlorinated swimming pools is associated with airway changes similar to those seen in mild asthma, but with higher mucin expression. These changes were independent from airway hyperresponsiveness. The long-term physiological and clinical consequences of these changes remain to be clarified. (Source: Journal of Allergy and Clinical Immunology)

Matrix‐assisted laser desorption/ionization mass spectrometry reveals decreased calcylcin expression in small cell lung cancer

Pathology International — Thu, 22 Dec 2011 17:25:00 +0100

To date, most of the proteomic analyses on lung cancer tissue samples have been performed using surgical specimens, which are obtained after a diagnosis is made. To determine if a proteomic signature obtained from bronchoscopic biopsy samples could be found to assist with diagnosis, 50 lung cancer bronchoscopic biopsy samples and 13 adjacent normal lung tissue samples were analyzed using histology‐directed, matrix‐assisted laser desorption/ionization (MALDI) mass spectrometry (MS). Lung tissue samples were cryosectioned, and sinapinic acid was robotically deposited on areas of each tissue section enriched in epithelial cells, either tumor or normal. Mass spectra were acquired using a MALDI‐time of flight instrument. Small cell lung cancers (SCLCs) demonstrated clearly different prote...

Lung Cancer following Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Case and Its Management

Respiration — Tue, 20 Dec 2011 23:00:00 +0100

Respiration (DOI:10.1159/000334312) (Source: Respiration)

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Algorithm for Video Summarization of Bronchoscopy Procedures

BioMedical Engineering OnLine — Tue, 20 Dec 2011 05:00:00 +0100

Conclusions: The paper focuses on the challenge of generating summaries of bronchoscopy video recordings. (Source: BioMedical Engineering OnLine)

Successful resection of a glomus tumor of the trachea

General Thoracic and Cardiovascular Surgery — Thu, 15 Dec 2011 16:44:31 +0100

We present a case of a surgically resected glomus tumor of the trachea in a 56-year-old woman who presented with worsening dyspnea and cough. Bronchoscopy and computed tomography showed a polypoid tumor arising from the posterior membrane of the lower trachea just above the carina; the tracheal lumen was approximately 80% occluded. The patient underwent successful tracheal sleeve resection with primary reconstruction. The histological characteristics and immunohistochemical profile were typical for this tumor. The clinicopathological features of this unusual neoplasm are discussed, and the literature is reviewed. Content Type Journal ArticleCategory Case ReportPages 815-818DOI 10.1007/s11748-010-0772-yAuthors Akira Mogi, Department of General Surgical Science, Gunma University ...

The clinical implications of bronchoscopy in hemoptysis patients with no explainable lesions in computed tomography

Respiratory Medicine — Wed, 14 Dec 2011 05:00:00 +0100

Conclusion: The recurrence rate was higher in the patients with positive findings than in the patients with negative findings on bronchoscopy. Although about 20% of patients with negative bronchoscopy findings experienced recurrence, the clinical course of those in whom recurrent bleeding occurred was usually benign. (Source: Respiratory Medicine)

Endobronchial findings of hydatid cyst disease: A report of five pediatric cases

Pediatric Pulmonology — Tue, 13 Dec 2011 05:00:00 +0100

This study examines the findings of endobronchial hydatid cyst disease in five pediatric patients from Turkey, and clinical experience about this subject is reviewed. All our patients presented with unusual symptoms of the disease, and for all of them, diagnosis had been delayed using current diagnostic methods. As a result of our experience, it can be reported that the endobronchial appearance of the hydatid cyst membrane is whitish‐yellow, and it is difficult to differentiate it radiologically from some other common causes of endobronchial lesions in childhood, such as endobronchial tuberculosis, foreign body aspirations, mucous plaques, and granulation scars. The findings of these cases show that, hydatid cyst should also be kept in mind in differential diagnosis of endobronchial lesi...

Pulmonary function and long‐term follow‐up of children with tracheobronchomalacia

Pediatric Pulmonology — Tue, 13 Dec 2011 05:00:00 +0100

ConclusionsClinical symptom profiles and pulmonary function indicate persistent functional mechanical abnormalities of the large and small airways in TBM patients, and the absence of reactive airways disease. Pediatr Pulmonol. © 2011 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)

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Pneumocystis Pneumonia

Seminars in Respiratory and Critical Care Medicine — Tue, 13 Dec 2011 05:00:00 +0100

Semin Respir Crit Care Med 2011; 32: 775-782DOI: 10.1055/s-0031-1295725ABSTRACTPneumocystis (carinii) jiroveci pneumonia can occur in immunocompromised individuals, especially hematopoietic stem and solid organ transplant recipients and those receiving immunosuppressive agents, and is the most common opportunistic infection in persons with advanced human immunodeficiency virus (HIV) infection. The Pneumocystis genus was initially mistaken as a trypanosome and later as a protozoan. Genetic analysis identified the organism as a unicellular fungus. Pneumocystis jiroveci is the species responsible for human infections. A slow indolent time course with symptoms of pneumonia progressing over weeks to months is characteristic in HIV-infected patients. Fulminant respiratory failure associated with...

An analysis of potential risk factors for early complications from fiberoptic bronchoscopy in lung transplant recipients

Transplant International — Mon, 12 Dec 2011 05:00:00 +0100

SummarySeveral reviews exist describing the safety of bronchoscopy in lung transplant recipients. However, the incidence of bronchoscopic complications in lung transplant recipients in relation to trainee involvement, and clinical characteristics such as pre‐transplant diagnosis and transplant type, has not been described. We performed a retrospective cohort study of all lung transplant recipients undergoing flexible fiberoptic bronchoscopy (n = 259) at the University of California, San Francisco, between January, 2003, and June, 2009. Complications included bleeding, pneumothorax, aspiration, oversedation, and hypoxemia. From 2003 to 2009, 3734 flexible fiberoptic bronchoscopies were performed, including 2111 (57%) with transbronchial biopsies. Trainees were involved in 2102 broncho...

Diagnostic yield of bronchoscopic sampling in febrile neutropenic patients with pulmonary infiltrate and haematological disorders

Internal Medicine Journal — Thu, 08 Dec 2011 05:00:00 +0100

Conclusions In haematology patients presenting with febrile neutropenia and pulmonary infiltrate, bronchoscopy is a safe procedure which plays a significant role in management. (Source: Internal Medicine Journal)

Pulmonary Masses: Initial Results of Cone-beam CT Guidance with Needle Planning Software for Percutaneous Lung Biopsy

CardioVascular and Interventional Radiology — Wed, 07 Dec 2011 10:47:04 +0100

Conclusion CBCT guidance is an effective method for PLB, with results comparable to CT/CT fluoroscopy guidance. Content Type Journal ArticleCategory Clinical InvestigationPages 1-8DOI 10.1007/s00270-011-0302-zAuthors Sicco J. Braak, Department of Radiology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, EM Nieuwegein, The NetherlandsGerarda J. M. Herder, Department of Pulmonology, St. Antonius Hospital, Nieuwegein, The NetherlandsJohannes P. M. van Heesewijk, Department of Radiology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, EM Nieuwegein, The NetherlandsMarco J. L. van Strijen, Department of Radiology, St. Antonius Hospital, P.O. Box 2500, 3430 EM, EM Nieuwegein, The Netherlands Journal CardioVascular and Interventional RadiologyOnline ISSN 1432-086XPrint I...

Endobronchial echinococcosis presenting as non‐resolving pneumonia

Pediatric Pulmonology — Wed, 07 Dec 2011 05:00:00 +0100

We present the case of a patient evaluated for non‐resolving pneumonia whose radiographic and bronchoscopic findings were strikingly similar to those seen in pulmonary tuberculosis with endobronchial invasion; he was ultimately diagnosed with pulmonary echinococcosis. This case underscores the importance of considering unusual diagnoses even when typical features of more common conditions are present. Pediatr Pulmonol. © 2011 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)

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Tracheo-Bronchial Foreign Body Aspiration in Children: A One Year Descriptive Study

Indian Journal of Otolaryngology and Head and Neck Surgery — Tue, 06 Dec 2011 17:01:08 +0100

This study was conducted in Department of Otorhinolaryngology, K.L.E.S Dr. Prabhakar Kore Hospital, Belgaum, for a period of 1 year. Children less than 16 years of age with history suggestive or suspicious of foreign body aspiration were screened clinically and radiologically and those patients with high index of suspicion of foreign body were included in the study. All patients were subjected to rigid bronchoscopy under general anaesthesia and the results were analyzed. This study comprises of 29 patients with suspected foreign body aspiration. On rigid bronchoscopy, foreign body was found and successfully removed in 22 patients. Highest incidence was seen in boys between 1 and 2 years age. History of foreign body aspiration was absent in most cases and children prese...

The presence of pepsin in the lung and its relationship to pathologic gastro‐esophageal reflux

Neurogastroenterology and Motility — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions & Inferences Lung pepsin cannot predict pathologic reflux in the esophagus, but its correlation with lung inflammation suggests that pepsin may be an important biomarker for reflux‐related lung disease. (Source: Neurogastroenterology and Motility)

Airway Ultraflex Stenting in Esophageal Cancer with Esophagorespiratory Fistula.

The American Journal of the Medical Sciences — Fri, 02 Dec 2011 05:00:00 +0100

CONCLUSIONS: Surgical treatment remains the first choice in patients with esophageal cancer with ERF; however, the authors provided an alternative airway stenting for those patients whom surgery is unsuitable. It improved survival in the group with airway stenting than those without. Performance status improvement and further treatment for esophageal cancer may improve survival, but prolonged pneumonia may worsen survival. PMID: 22143123 [PubMed - as supplied by publisher] (Source: The American Journal of the Medical Sciences)

A New Tool for Extreme IVC Filter Removal

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

We describe the first intravascular use of a steerable laparoscopic grasping forcep to remove an embedded IVC filter. (Source: Journal of Vascular Surgery)

Anaesthetic equipment for thoracic surgery

Anaesthesia and intensive care medicine — Thu, 01 Dec 2011 05:00:00 +0100

This article outlines the development and use of the currently available double-lumen tubes and bronchus blockers. It concludes with some comparisons between the two methods of lung isolation. (Source: Anaesthesia and intensive care medicine)

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Fibreoptic bronchoscopic positioning of double-lumen tubes

Anaesthesia and intensive care medicine — Thu, 01 Dec 2011 05:00:00 +0100

Abstract: Double-lumen tubes should be placed using a fibreoptic bronchoscope. This allows correct positioning of the bronchial lumen in the chosen mainstem bronchus. It also ensures that the blue bronchial cuff does not obstruct the side to be ventilated when it is inflated under direct vision. Fibreoptic bronchoscopy facilitates correct positioning of the ventilatory side slot of a right double-lumen tube over the right upper lobe bronchus. The anaesthetist must know the fibreoptic tracheo-bronchial anatomy to properly position left- and right-sided double-lumen tubes (DLTs) and should always reconfirm the position of a DLT with fibreoptic bronchoscopy after repositioning the patient. Maintaining orientation (anterior–posterior) during fibreoptic bronchoscopy is crucial to position a D...

Limited short term steroid responsiveness is associated with thickening of bronchial basement membrane in severe asthma.

Chest — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion and clinical relevanceFeatures of airway remodelling are associated with limited short-term steroid responsiveness in severe asthma. PMID: 22135380 [PubMed - as supplied by publisher] (Source: Chest)

Perioperative management of a patient with a massive lipomatous mediastinal mass, severe cardiomyopathy, and tracheal stenosis for urgent laser bronchoscopy and stent placement

Journal of Clinical Anesthesia — Thu, 01 Dec 2011 05:00:00 +0100

We describe the anesthetic management of a patient who had both severe intrinsic and extrinsic airway compression, as well as multiple medical comorbidities, who presented to the operating room (OR) for further management of his airway disease. (Source: Journal of Clinical Anesthesia)

Bronchoscopic evaluation of the mediastinum using endobronchial ultrasound: a description of the first 216 cases carried out at an Australian tertiary hospital

Internal Medicine Journal — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: EBUS‐TBNA is able to confirm accurately histologically a large number of disease processes, both malignant and benign, in all clinical indications studied. The procedure is safe even when carried out by proceduralists with minimal prior experience. Diagnostic performance continues to improve beyond 50 cases carried out. (Source: Internal Medicine Journal)

The Insertion of Self Expanding Metal Stents With Flexible Bronchoscopy Under Sedation for Malignant Tracheobronchial Stenosis: A Single-Center Retrospective Analysis.

Archivos de Bronconeumologia — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION: Ultraflex stents offer a safe and effective therapy for patients who are inoperable or unresectable that otherwise would have no alternative therapy. It has an immediate beneficial effect upon patients, not only through symptom relief but, in some, through prolongation of life. Survival data is no worse than other studies using different varieties of stents and insertion techniques indicating its longer-term efficacy. Moreover, this report highlights the feasibility of performing this procedure successfully in a respiratory unit, without the need for general anesthesia. PMID: 22137422 [PubMed - as supplied by publisher] (Source: Archivos de Bronconeumologia)

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Pulmonary Resection for Airway Complication After Lung Transplantation in a Patient with Cystic Fibrosis: A Case Report

Transplantation Proceedings — Thu, 01 Dec 2011 05:00:00 +0100

We report a case of the interdisciplinary management of recurring bronchial stenosis after bilateral sequential single-lung transplantation (BSSLT) in a 35-year-old female with cystic fibrosis. Initial bronchoscopic therapy including balloon dilatation, stenting, and cryotherapy for granulation tissue overgrowth was unsuccessful in maintaining airway patency. In view of the persistent left lower lobe (LLL) atelectasis and fibrosis predisposing to recurrent infections, she was submitted for left lower lobectomy. (Source: Transplantation Proceedings)

A case of mediastinal lymph node carcinoma of unknown primary site treated with docetaxel and Cisplatin with concurrent thoracic radiation therapy.

Acta Med Okayama — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Shiota Y, Imai S, Sasaki N, Tahara K, Noma B, Horita N, Taniguchi A, Ono T Abstract Mediastinal lymph node carcinoma of unknown primary site is rare and may have a better prognosis if extensive treatment is performed. Case, A 69-year-old-male presented with a persistent cough. Chest computed tomography (CT) demonstrated a large tumor 9.5×8.2cm, in the mediastinum, compressing the right main bronchus, the right pulmonary artery, and the superior vena cava. Because fiberoptic bronchoscopy was insufficient for diagnosis, mediastinoscopic tumor biopsy under general anesthesia was undertaken. Histological examination revealed adenocarcinoma. Extensive examinations revealed no other neoplastic lesion except in the mediastinum. Mediastinal lymph node carcinoma of unknown primary...

[The importance of bronchoscopic anatomy for anesthesiologists].

Tuberkuloz ve Toraks — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Hoşten T, Topçu S Abstract One-lung ventilation (OLV) is a sine qua non of thoracic surgery and requires knowledge and talent. Close familiarity with equipments used for OLV as well as bronchoscopy and respiratory tract anatomy is important for successful OLV. We aim to outline the bronchoscopic anatomy of the tracheobronchial tree and OLV equipment for anesthetists and thoracic surgeons in this review. The recorded preoperative and intraoperative bronchoscopic applications of the patients hospitalized in our Thoracic Surgery clinic for diagnosis and treatment have been evaluated from an anesthetist's perspective. Anatomic landmarks were identified in the bronchoscopic evaluation. Optimal and misplacement images of double-lumen tubes (DLT) and bronchial blockers (BB) use...

Lung adenocarcinoma with endobronchial growth.

Tuberkuloz ve Toraks — Thu, 01 Dec 2011 05:00:00 +0100

We report a rare case of lung adenocarcinoma with endobronchial growth in a 65-year-old woman. Chest computed tomography revealed an ill-defined mass in the lower lobe of the left lung and multiple sized nodular shadows in the both lungs. An endobronchial polypoid tumor in the left B8 bronchus was found by bronchoscopic examination. A biopsy specimen obtained from the tumor diagnosed lung adenocarcinoma. Although very rare, we should therefore keep in mind that patients who have a pulmonary tumor adjacent to the bronchus with an endobronchial polypoid lesion may have lung adenocarcinoma. PMID: 22233312 [PubMed - in process] (Source: Tuberkuloz ve Toraks)

Community-acquired Burkholderia cepacia pneumonia: a report of two immunocompetent patients.

Tuberkuloz ve Toraks — Thu, 01 Dec 2011 05:00:00 +0100

This report is about two patients with no underlying disease diagnosed as B. cepacia pneumonia mimicking malignancy and tuberculosis. Bronchoscopy was applied on both patients since no response to treatment with wide spectrum antibiotics and negative sputum smears for acid-fast bacili. B. cepacia was isolated from bronchial lavage culture. Antibiogram revealed sensitivity to quinolones in both cases. Radiological and clinical complete remission was seen in patients by quinolones. The current cases showed that community-acquired Burkholderia pneumonia is possible in healthy patients. Bronchial washing is important in diagnosis. PMID: 22233309 [PubMed - in process] (Source: Tuberkuloz ve Toraks)

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Growth of a solitary pulmonary nodule after 6 years diagnosed as oncocytic carcinoid tumour with a high 18‐fluorodeoxyglucose (fdg) uptake in positron emission tomography‐computed tomography (pet‐ct)

The Clinical Respiratory Journal — Wed, 30 Nov 2011 05:00:00 +0100

Conclusion: We present a rare case of an oncocytic carcinoid tumour with an increase in the size of a solitary pulmonary nodule after 6 years’ follow‐up. In addition, PET‐CT showed a very high FDG uptake in this patient, which is an unexpected finding with a pulmonary carcinoid tumour. (Source: The Clinical Respiratory Journal)

Growth of a solitary pulmonary nodule after 6 years diagnosed as oncocytic carcinoid tumour with a high 18‐fluorodeoxyglucose (18F‐FDG) uptake in positron emission tomography‐computed tomography (PET‐CT)

The Clinical Respiratory Journal — Wed, 30 Nov 2011 05:00:00 +0100

Conclusion: We present a rare case of an oncocytic carcinoid tumour with an increase in the size of a solitary pulmonary nodule after 6 years' follow‐up. In addition, PET‐CT showed a very high 18F‐FDG uptake in this patient, which is an unexpected finding with a pulmonary carcinoid tumour.Please cite this paper as: Turan O, Ozdogan O, Gurel D, Onen A, Kargi A and Sevinc C. Growth of a solitary pulmonary nodule after 6 years diagnosed as oncocytic carcinoid tumour with a high 18F‐FDG uptake in positron emission tomography‐computed tomography (PET‐CT). Clin Respir J 2011; DOI:10.1111/j.1752‐699X.2011.00274.x. (Source: The Clinical Respiratory Journal)

Tracheo-Bronchial Foreign Bodies: A Retrospective Study and Review of Literature

Indian Journal of Otolaryngology and Head and Neck Surgery — Wed, 30 Nov 2011 04:38:47 +0100

Abstract Tracheobronchial foreign body aspiration is a common emergency in childhood constituting major cause of mortality. Although ample studies regarding airway foreign bodies are present in western literature, studies in Indian context are however lacking. The aim of the study is to present an epidemiological data regarding airway foreign bodies in Indian context thereby helping to analyze the situation with regard to our socio-economic condition. Retrospective file review of all case (n = 82) that underwent rigid bronchoscopy for suspected tracheo-bronchial foreign body over a period of 7 years (2001–2008) in the department of otolaryngology of a tertiary care centre of eastern India. Patient characteristics, history, clinical, radiographic and broncho...

Frontiers in Bronchoscopic Imaging

Respirology — Tue, 29 Nov 2011 05:00:00 +0100

AbstractBronchoscopy is a minimally‐invasive method for diagnosis of diseases of the airways and the lung parenchyma. Standard bronchoscopy uses the reflectance/scattering properties of white light from tissue to examine the macroscopic appearance of airways. It does not exploit the full spectrum of the optical properties of bronchial tissues. Advances in optical imaging such as optical coherence tomography (OCT), confocal endomicroscopy, autofluorescence imaging and laser Raman spectroscopy are at the forefront to allow in‐vivo high resolution probing of the microscopic structure, biochemical compositions and even molecular alterations in disease states. OCT can visualize cellular and extracellular structures at and below the tissue surface with near histologic resolution as well as t...

Surgical management of distal tracheal stenosis in children

The Laryngoscope — Fri, 25 Nov 2011 08:40:15 +0100

Conclusions:Improvements in operative techniques and perioperative management have led to significant decreases in morbidity and mortality. At our institution, slide tracheoplasty has become the preferred technique for all except very short segment stenosis, and cardiopulmonary bypass is used in all cases involving the distal trachea. Laryngoscope, 121:2665–2671, 2011 (Source: The Laryngoscope)

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Anesthesia in an adult patient with tracheal hemangiomas: one-lung ventilation for lung lobectomy

Journal of Anesthesia — Thu, 24 Nov 2011 17:50:37 +0100

We report the case of a patient with tracheal hemangiomas undergoing nontracheal operation. A 61-year-old woman was scheduled for a lung operation. During preoperative examination, hemangiomas were detected on the tracheal mucosa. As she was asymptomatic and the degree of airway stenosis was small, treatment was not required for the hemangiomas, and left upper lobectomy for lung cancer was scheduled. After induction of general anesthesia, a regular tracheal tube was inserted under fiberoptic bronchoscopy, with care taken to prevent damage to the hemangiomas. An endobronchial blocker was inserted for one-lung ventilation. The operation was performed uneventfully, and the tracheal tube was replaced postoperatively with a laryngeal mask airway while the patient was under deep anesthesia...

Bronchoscopic Lung Volume Reduction Coil treatment of patients with severe heterogeneous emphysema.

Chest — Wed, 23 Nov 2011 05:00:00 +0100

ConclusionsLVR-coil treatment is a promising technique for the treatment of patients with severe heterogeneous emphysema. The treatment is technically feasible and results in significant improvements in pulmonary function, exercise capacity and quality of life with an acceptable safety profile. PMID: 22116796 [PubMed - as supplied by publisher] (Source: Chest)

Contemporary Bronchoscopy Training and Assessment: A la recherche du professionnalisme perdu?

Karger Publishers — Mon, 21 Nov 2011 23:00:00 +0100

Respiration (DOI:10.1159/000334399) (Source: Karger Publishers)

Contemporary Bronchoscopy Training and Assessment: A la recherche du professionnalisme perdu

Respiration — Mon, 21 Nov 2011 23:00:00 +0100

Respiration (DOI:10.1159/000334399) (Source: Respiration)

Bronchial Thermoplasty: A New Treatment Paradigm for Severe Persistent Asthma

Clinical Reviews in Allergy and Immunology — Mon, 21 Nov 2011 18:06:10 +0100

Abstract Patients with severe asthma represent only a minority of the total asthma population; however, they account for the majority of the mortality, morbidity, and health care-related cost of this chronic illness. Bronchial thermoplasty is a novel treatment modality that employs radiofrequency energy to alter the smooth muscles of the airways. This therapy represents a radical change in our treatment paradigm from daily repetitive dosing of medications to a truly long-term and potentially permanent attenuation of perhaps the most feared component of asthma—smooth muscle-induced bronchospasm. A large, multicentered, double-blinded, randomized controlled trial employed the unprecedented (but now industry standard for bronchoscopic studies) approach of using sham broncho...

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Clinical Outcomes of Linezolid vs Vancomycin in Methicillin-Resistant Staphylococcus aureus Ventilator-Associated Pneumonia: Retrospective Analysis

Journal of Intensive Care Medicine — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions: Our results suggested no survival benefit but a trend toward higher cure rate with linezolid therapy. The optimal treatment of MRSA VAP requires further study through randomized, controlled trials. (Source: Journal of Intensive Care Medicine)

Bronchoscopic diagnosis of pulmonary hydatid cyst.

cmaj — Mon, 21 Nov 2011 05:00:00 +0100

Authors: Madan K, Singh N PMID: 22105751 [PubMed - as supplied by publisher] (Source: cmaj)

Endobronchial Hamartoma Removed Completely  by Bronchoscopic Electrosurgical Snaring: A Case Report

Chinese Journal of Lung Cancer — Sun, 20 Nov 2011 05:00:00 +0100

DOI: 10.3779/j.issn.1009-3419.2011.11.13 (Source: Chinese Journal of Lung Cancer)

Sputum induction for the diagnosis of pulmonary tuberculosis: a systematic review and meta-analysis

European Journal of Clinical Microbiology and Infectious Diseases — Fri, 18 Nov 2011 06:55:55 +0100

Abstract Sputum induction (SI) has been proposed as the optimal sample collection method for patients with paucibacillary tuberculosis (TB). Studies reporting the culture of Mycobacterium tuberculosis from SI were reviewed. A random-effects meta-analysis of diagnostic yield (numerator M. tuberculosis SI culture-positive cases; denominator all culture-positive cases) was conducted. Diagnostic yields (95% confidence intervals, CIs) were displayed as Forest plots. Heterogeneity was evaluated using Chi-squared and I-squared tests and meta-regression analysis. Ninety publications were screened, 28 full-text papers reviewed, and 17 analyzed. Collectively, n = 627 SI culture-positive cases among n = 975 culture-confirmed TB cases were reported. The diagnostic yield of SI ran...

Tracheobronchial malposition of fine bore feeding tube in patients with mechanical ventilation

BioMed Central — Fri, 18 Nov 2011 05:00:00 +0100

In order to alert the potential risk for tracheobronchial misplacement of the feeding tube in those patients with endotracheal intubation or tracheostomy, we report tracheobronchial malposition of the feeding tube in six patients with mechanical ventilation from January 2008 to August 2011. Tracheobronchial misplacement of the feeding tube was found in two patients by bronchoscopy, chest radiography confirmed malposition of the tube in four patients. Neither auscultation of bubbling sounds over epigastrium after insufflation of air nor aspiration of "gastric content" is thought to be reliable. We should use pH test of gastric aspirate as the first line test, with pH between 1 and 5.5 as the safe range; and X-ray is used as the second line test. Cautions should be taken for interpretation o...

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Transbronchial fine needle aspiration biopsy and rapid on‐site evaluation in the setting of superior vena cava syndrome

Diagnostic Cytopathology — Fri, 18 Nov 2011 05:00:00 +0100

AbstractThere is a paucity of prospective data on flexible bronchoscopy with rapid on‐site evaluation (ROSE) in the setting of superior vena cava (SVC) syndrome. The aims of this prospective study were to assess the diagnostic yield and safety of these investigations and specifically to evaluate the role of ROSE in limiting the need for tissue biopsies. Over a 5‐year period 48 patients (57.4 ± 9.7 years) with SVC syndrome secondary to intrathoracic tumors underwent flexible bronchoscopy with TBNA and ROSE. Endobronchial Forceps biopsy was reserved for visible endobronchial tumors with no on‐site confirmation of diagnostic material. ROSE confirmed diagnostic material in 41 cases (85.4%), and in only one of the remaining cases did the addition of a forceps biopsy increase the diagnost...

A pulmonary abscess, beware of lung cancer!

Respiratory Medicine CME — Thu, 17 Nov 2011 12:48:12 +0100

We present two patients with a pulmonary abscess caused by an underlying lung cancer. Although in both cases the differential diagnosis was malignancy at first presentation, the diagnosis could not be made definitively prior to surgery, despite intensive investigations with even CT guided biopsies and mediastinoscopy. (Source: Respiratory Medicine CME)

Bronchial artery embolization: Managing ruptured pulmonary artery venous malformation – A case report

Respiratory Medicine CME — Thu, 17 Nov 2011 12:48:12 +0100

Abstract: A young 19 year old boy reported to the emergency with complaints of productive cough and mild haemoptysis over three days duration. Initial investigations were within normal limits. Symptoms suddenly aggravated and his condition deteriorated severely before further sophisticated investigations could be carried out. Urgent diagnostic bronchoscopy indicated it to be a case of spontaneously ruptured micro-vascular Pulmonary Arterio-Venous Malformation (PAVM) which was further confirmed on performing pulmonary angiography. Diameter of the feeding vessel was narrow causing difficulty in negotiating for coil embolotherapy. Occlusion of the bleeding artery was finally achieved by pushing in gel foam particles through the vessel. The boy recovered completely and remained asymptomatic on...

Another new tool for the diagnostic bronchoscopist

Thorax — Thu, 17 Nov 2011 05:00:00 +0100

Solitary pulmonary nodules (SPNs), defined as rounded lesions <3 cm completely surrounded by an aerated lung, are increasingly identified by modern chest radiography and thoracic CT. As CT screening studies report and the debate over the place of national lung cancer screening programmes intensifies, the need for algorithms to efficiently investigate SPNs will become even more important.1 Peripheral pulmonary lesions can be biopsied by various techniques. The most commonly used approach in the UK is transthoracic needle aspiration or core biopsy usually performed under CT guidance. The diagnostic sensitivity for malignancy exceeds 90% in experienced hands but up to 44% of biopsies in benign disease are non-diagnostic.2 While generally safe, it is not without complications; in a lar...

Virtual bronchoscopic navigation combined with endobronchial ultrasound to diagnose small peripheral pulmonary lesions: a randomised trial

Thorax — Thu, 17 Nov 2011 05:00:00 +0100

Conclusions The diagnostic yield for small peripheral pulmonary lesions is increased when VBN is combined with EBUS. Clinical trial number UMIN000000569. (Source: Thorax)

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Pulmonary and cutaneous nodules in an immunocompromised patient

Thorax — Thu, 17 Nov 2011 05:00:00 +0100

Clinical presentation A 74-year-old man was admitted to hospital due to dyspnoea, malaise and purple, plaque-like papular nodules on his hands (figure 1A), soles (figure 1B) and genitalia for a duration of 1 month. He reported a 5-month history of systemic corticosteroid use for treatment of giant cell arteritis. Laboratory tests disclosed severe lymphopenia and hypogammaglobulinaemia. Pancultures and serological tests were negative, including repeated HIV serology. Contrast-enhanced CT of the chest (2.5 mm slice thickness) demonstrated multiple bilateral solid pulmonary nodules with peribronchovascular distribution and a cavitating nodule in the left lower lobe (figure 1C). Abdominal CT revealed multiple hepatic ring-enhancing lesions (figure 1D). A bronchoscopy for inspection, ...

Coral broncholith associated with cystic bronchiectasis

Thorax — Thu, 17 Nov 2011 05:00:00 +0100

We present an unusual type of broncholithiasis complicated with cystic bronchiectasis. Chest CT scans showed cystic bronchiectasis with fluid collection in the right lower lobe and calcification was also detected in the right lower bronchus (figure 1A,B). Bronchoscopy showed a ‘coral’ broncholith arising from the right lower bronchus (figure 2A,B). Broncholithiasis is commonly caused by erosion and extrusion of a calcified adjacent lymph node into the bronchial lumen, a finding usually associated with tuberculosis or histoplasmosis.1 In the present case, cystic bronchiectasis might be associated with broncholith formation. Learning points This case is the first report of the ‘coral’ broncholith. Cystic bronchiectasis might be associated with the broncholith formatio...

Severe Asthma: Lessons Learned from the NHLBI Severe Asthma Research Program.

American Journal of Respiratory and Critical Care Medicine — Thu, 17 Nov 2011 05:00:00 +0100

Authors: Jarjour NN, Erzurum SC, Bleecker ER, Calhoun WJ, Castro M, Comhair SA, Chung KF, Curran-Everett D, Dweik RA, Fain SB, Fitzpatrick AM, Gaston BM, Israel E, Hastie A, Hoffman EA, Holguin F, Levy BD, Meyers DA, Moore WC, Peters SP, Sorkness RL, Teague WG, Wenzel SE, Busse WW Abstract The National Heart, Lung and Blood Institute (NHLBI) Severe Asthma Research Program (SARP) has characterized over the past 10 years 1644 asthmatic patients, including 583 individuals with severe asthma. SARP collaboration has led to a rapid recruitment of subjects and efficient sharing of samples among participating sites to conduct independent mechanistic investigations of severe asthma. Enrolled SARP subjects underwent detailed clinical, physiologic, genomic, and radiological evaluations. In ad...

Successful treatment of severe asthma-associated plastic bronchitis with extracorporeal membrane oxygenation

Journal of Anesthesia — Wed, 16 Nov 2011 16:46:42 +0100

We describe a case of near-fatal asthma requiring extracorporeal membrane oxygenation (ECMO). The patient presented with severe respiratory distress, which was not responsive to conventional pharmacological therapy. The patient also failed to respond to mechanical ventilation and thus was placed on venovenous ECMO for temporary pulmonary support. A fiberoptic bronchoscopy revealed that large amounts of thick bronchial secretions had occluded the main bronchus, which suggested plastic bronchitis secondary to asthma. Aggressive airway hygiene with frequent bronchoscopies and application of biphasic cuirass ventilation for facilitation of secretion clearance were performed to improve the patient’s respiratory status. The patient achieved a full recovery and suffered no neurological se...

Computer-Based Route-Definition System for Peripheral Bronchoscopy

Journal of Digital Imaging — Tue, 15 Nov 2011 06:47:44 +0100

We present a system for the robust definition of complete airway routes suitable for image-guided bronchoscopy. The system incorporates both automatic and semiautomatic MDCT analysis methods for this purpose. Using an intuitive graphical user interface, the user invokes automatic analysis on a patient’s MDCT scan to produce a series of preliminary routes. Next, the user visually inspects each route and quickly corrects the observed route defects using the built-in semiautomatic methods. Application of the system to a human study for the planning and guidance of peripheral bronchoscopy demonstrates the efficacy of the system. Content Type Journal ArticlePages 1-11DOI 10.1007/s10278-011-9433-7Authors Michael W. Graham, Department of Electrical Engineering, Penn State University...

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Postoperative bronchial stump fistula after lobectomy: response to occlusion with polyglycolic acid mesh and fibrin glue via bronchoscopy

General Thoracic and Cardiovascular Surgery — Mon, 14 Nov 2011 17:03:37 +0100

Abstract Bronchial stump fistula after resection of lung cancer is an extremely difficult to treat postoperative complication. Endoscopic fistula closure is a favorable alternative, potentially avoiding major surgical intervention. an 80-year-old man underwent curative resection of squamous cell carcinoma by left upper lobectomy of the lung. The patient suddenly developed massive subcutaneous emphysema on postoperative day 10. Bronchoscopy revealed a fistula about 3 mm in diameter at the lateral edge of the bronchial stump. Concentrated fibrinogen 0.5 ml (fluid A) was sprinkled on the bronchial fistula initially, and then pieces of polyglycolic acid mesh presoaked in fluid A or fluid B (thrombin) of the fibrin glue were pushed with biopsy forceps into the fistula in an alt...

An uncommon hazard: Pulmonary talcosis as a result of recurrent aspiration of baby powder

Respiratory Medicine CME — Sun, 13 Nov 2011 21:28:38 +0100

Abstract: A previously healthy 52-year old woman presented to the hospital with a 6-month history of progressive dyspnea. Associated symptoms included a persistent dry cough that started 2 months prior admission and an unintentional weight loss of 20 pounds over the course of her illness. On lung examination revealed fine bilateral end-inspiratory crackles in both lower and upper lobes. Radiographic studies showed evidence of interstitial lung disease. The patient underwent bronchoscopy were transbronchial biopsies were taken and showed fibrosis of bronchial walls and lung parenchyma with prominent non-necrotizing granulomata that contained abundant polarizing crystalline material. Once the pathologic findings were known, the patient was re-interviewed. She reported that for the last 20-ye...

Biphasic flow volume curve due to obstruction of main bronchus by bronchogenic cyst

Respiratory Medicine CME — Sun, 13 Nov 2011 21:28:38 +0100

We report the case of a 64-year-old woman, with progressive dyspnea, coughing and wheezing localized in the left hemithorax, who had been diagnosed with bronchial asthma and was not responding to treatment. The flow volume curve showed an end inspiratory arm configuration compatible with unilateral obstruction of a main bronchus. Chest computed tomography with three-dimensional reconstruction showed a left main bronchus compression by a cyst formation, the bronchoscopy confirmed the obstruction. At surgery a bronchogenic cyst was resected.After the procedure, dyspnea, cough, expectoration and wheezing disappeared. The postoperative flow volume curve showed a normal configuration. We are not aware of a previous report of a biphasic flow volume curve due to a mediastinal bronchogenic cyst.Th...

Tracheal intubation in an unanticipated difficult airway by advancing a bronchoscope and a tracheal tube introducer through a LMA Supreme™

Canadian Journal of Anaesthesia — Fri, 11 Nov 2011 05:00:00 +0100

Authors: Chu QJ, Han XP, Mak HY, Wong DT PMID: 22076862 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

Evaluation of simulation training in cardiothoracic surgery: The Senior Tour perspective

The Journal of Thoracic and Cardiovascular Surgery — Fri, 11 Nov 2011 05:00:00 +0100

Conclusions: By providing the necessary tools, such as task trainers and assessment instruments, the Senior Tour may be one means to enhance simulation-based learning in cardiothoracic surgery. The Senior Tour members can provide regular programmatic evaluation and critical analyses to ensure that proposed simulators are of educational value. (Source: The Journal of Thoracic and Cardiovascular Surgery)

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Posture influences patient cough rate, sedative requirement and comfort during bronchoscopy: An observational cohort study.

Cough — Thu, 10 Nov 2011 05:00:00 +0100

Conclusions: Bronchoscopy performed in the semi-recumbent posture results in less cough and sedative requirement, and may improve patient comfort. (Source: Cough)

The Electrosurgical Knife in an Optimized Intermittent Cutting Mode for the Endoscopic Treatment of Benign Web-Like Tracheobronchial Stenosis.

Archivos de Bronconeumologia — Thu, 10 Nov 2011 05:00:00 +0100

CONCLUSION: The use of this technique is effective for the treatment of benign web-like tracheobronchial stenosis as all the patients showed clinical and functional improvement, and less than 50% required a second intervention. In comparison with laser therapy, an advantage of this technique is that less fibrin is produced, probably due to the reduced anti-coagulation effect. PMID: 22079133 [PubMed - as supplied by publisher] (Source: Archivos de Bronconeumologia)

Bronchial Thermoplasty for Severe Asthma.

American Journal of Respiratory and Critical Care Medicine — Thu, 10 Nov 2011 05:00:00 +0100

Authors: Wahidi MM, Kraft M Abstract Bronchial thermoplasty (BT) is a novel treatment of patients with severe asthma who continue to be symptomatic despite maximal medical treatment. It aims to reduce the smooth muscle mass in the airways by delivering controlled thermal energy to the airway walls during a series of three bronchoscopies. Randomized controlled clinical trials of BT in severe asthma have not been able to show a reduction in airway hyperresponsiveness or change in FEV1 but have demonstrated an improvement in quality of life, as well as a reduction in the rate of severe exacerbations, emergency department visits, and days lost from school or work. The short-term adverse events consist primarily of bronchospasm and occasionally more severe events requiring hospitalizati...

ACCP Addresses Anesthesia for Bronchoscopy in AdultsACCP Addresses Anesthesia for Bronchoscopy in Adults

Medscape Today Headlines — Thu, 10 Nov 2011 00:53:16 +0100

The American College of Chest Physicians recommends that all physicians performing bronchoscopy consider the use of topical anesthesia, analgesic, and sedative agents when feasible. Medscape Medical News (Source: Medscape Today Headlines)

Indications and Outcome of Flexible Bronchoscopy in Neonates

Indian Journal of Pediatrics — Fri, 04 Nov 2011 16:54:24 +0100

Conclusions Flexible bronchoscopy is safe and useful both as diagnostic and therapeutic tool in neonates with respiratory problems. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s12098-011-0595-6Authors D. Vijayasekaran, Department of Pediatric Pulmonology, Institute of Child Health and Hospital for Children, Egmore, Chennai, IndiaS. Kalpana, Department of Pediatric Pulmonology, Institute of Child Health and Hospital for Children, Egmore, Chennai, IndiaP. Ramachandran, Department of Pediatric Pulmonology, Institute of Child Health and Hospital for Children, Egmore, Chennai, IndiaK. Nedunchelian, Department of Pediatric Pulmonology, Institute of Child Health and Hospital for Children, Egmore, Chennai, India Journal Indian Journal of Ped...

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Impact of 18F-FDG PET scan on the prevalence of benign thoracic lesions at surgical resection

Radiologia Brasileira — Fri, 04 Nov 2011 05:54:29 +0100

CONCLUSION: The introduction of FDG-PET scanning has not altered the proportion of patients undergoing thoracotomy for ultimately benign lesions, mainly due to the avidity for the isotope of some non-malignant lesions. Such false positive results need to be considered when patients with unconfirmed lung cancer are contemplated for surgical resection.OBJETIVO: A principal utilidade da tomografia por emissão de pósitrons com 18-fluordeoxiglicose (FDG-PET) está no estadiamento do câncer de pulmão. Porém, ela também pode ser utilizada para diferenciar lesões pulmonares indeterminadas, mas seu impacto na ressecção cirúrgica de lesões benignas é desconhecido. O objetivo deste estudo foi comparar a prevalência de lesões benignas em toracotomias feitas por suspeição de câncer de ...

Pulmonary artery sling: Current results with cardiopulmonary bypass

The Journal of Thoracic and Cardiovascular Surgery — Fri, 04 Nov 2011 04:00:00 +0100

Conclusions: Pulmonary artery sling is best repaired with median sternotomy, cardiopulmonary bypass, and left pulmonary artery reimplantation. This resulted in uniformly patent left pulmonary arteries in all patients. Preoperative computed tomography imaging, echocardiography, and bronchoscopy are essential for precise operative planning. The frequently associated tracheal stenosis is best repaired with slide tracheoplasty. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Discussion

The Journal of Thoracic and Cardiovascular Surgery — Fri, 04 Nov 2011 04:00:00 +0100

Dr Frank Hanley (Stanford, Calif). Your management approach to patients with pulmonary artery sling is both logical and clearly effective. It's an excellent study. I agree, and I suspect there is probably widespread agreement that both bronchoscopy and CT imaging are the preferred diagnostic procedures as well, in this day and age. I also tend to agree that the midline sternotomy approach with bypass, or at least with bypass standby, should be used in all cases. I have a few questions, and they cluster around some technical aspects of both the pulmonary artery reconstruction and then around the tracheal reconstruction. (Source: The Journal of Thoracic and Cardiovascular Surgery)

Endobronchial Metastases of Anal Canal Carcinoma.

Archivos de Bronconeumologia — Wed, 02 Nov 2011 04:00:00 +0100

Authors: Dalmases M, Lucena CM, Cano-Jiménez E, Xaubet A, Agustí C Abstract Endobronchial metastases (EBM) secondary to extrapulmonary primary tumours are rare. The most common solid malignant tumours associated with EBM are breast, renal and colorectal carcinomas. This case report describes the first documented case of EBM from anal canal carcinoma. This neoplasm constitutes less than 1% of colorectal tumours. The clinical presentation of this entity is variable, being asymptomatic in more than 50% of cases. Generally, EBM are diagnosed in advanced stages and the survival after the diagnosis is poor. It is therefore an exceptional clinical manifestation in which bronchoscopy has an important role in the diagnosis and the treatment. PMID: 22055765 [PubMed - as supplied by pub...

American college of chest physicians consensus statement on the use of topical anesthesia, analgesia, and sedation during flexible bronchoscopy in adult patients.

Chest — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS: We suggest that all physicians performing bronchoscopy consider using topical anesthesia, analgesic and sedative agents, when feasible. The existing body of literature supports the safety and effectiveness of this approach when the proper agents are used in an appropriately selected patient population. PMID: 22045879 [PubMed - in process] (Source: Chest)

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Interventional pulmonology.

The Medical Clinics of North America — Tue, 01 Nov 2011 04:00:00 +0100

This article is an introduction to pertinent interventions within the context of the diseases encountered by the trained interventional pulmonologist. PMID: 22032429 [PubMed - in process] (Source: The Medical Clinics of North America)

Myoepithelial carcinoma: First case reported in the trachea

Pathology International — Tue, 01 Nov 2011 04:00:00 +0100

We present the first documented case of a primary myoepithelial carcinoma in the trachea. The patient was a 23‐year‐old man who presented with shortness of breath and cough for four months. Bronchoscopy and computed tomographic (CT) scan revealed an intraluminal mass in the trachea. A standard sleeve of trachea resection with end‐to‐end reconstruction was performed. The tumor was mainly composed of spindle cells and epithelioid cells which exhibited relatively uniform nuclei with finely distributed chromatin and inconspicuous nucleoli, suggesting that it may arise from benign myoepithelioma. Moreover, the tumor displayed marked cytologic atypia and an infiltrative tumor border in some areas, suggesting that it was a malignant tumor. Immunohistochemically, the tumor cells were diffu...

Galactomannan detection in bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in patients with hematological diseases—the role of factors affecting assay performance

International Journal of Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

Conclusions: In contrast to recently published data, we found only moderate sensitivity, but high specificity and high positive predictive value of the detection of GM in BAL fluid. In addition, neutropenia, antifungal therapy, and BAL standardization affected GM assay performance. (Source: International Journal of Infectious Diseases)

Management of plastic bronchitis in a child with mild intermittent asthma.

The Annals of Otology, Rhinology, and Laryngology — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS: Plastic bronchitis in children is a rare condition that can mimic foreign body aspiration and can be associated with underlying pulmonary inflammatory disorders or cardiovascular disease. Aggressive bronchoscopic management of the airway obstruction and medical management of the underlying disease process are important for the successful treatment of plastic bronchitis. PMID: 22224309 [PubMed - in process] (Source: The Annals of Otology, Rhinology, and Laryngology)

Clinical implication of pulmonary excision for undiagnosed peripheral lung cancer

Interactive CardioVascular and Thoracic Surgery — Tue, 01 Nov 2011 04:00:00 +0100

Surgical excision is an option to diagnose small-sized lung cancer, although this procedure has potential to disseminate tumor cells from the surgical margin. This retrospective study enrolled 252 patients with clinical stage IA non-small cell lung carcinoma who had undergone lobectomy during the period 1998–2004. Except for 25 patients with ground-glass attenuation (GGA) lesions on computed tomography, all underwent preoperative biopsy using flexible fiberoptic bronchoscopy (FFB). A total of 148 patients were diagnosed by FFB, and 86 were diagnosed by surgical excision. In the surgical excision cases, 67 tumors were negative for malignancy at the surgical margins and 19 were positive. Diagnosis by surgical excision was associated significantly more often with smaller tumor size (P&l...

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Propranolol for the treatment of subglottic hemangiomas

International Journal of Pediatric Otorhinolaryngology — Tue, 01 Nov 2011 01:32:13 +0100

We present a retrospective chart review of infantile subglottic hemangiomas over a 5-year span (January 2005–2010) at a tertiary care pediatric hospital. IRB approval was obtained, and charts were reviewed to find patients with subglottic hemangiomas, including patient characteristics, presentation, workup, medical and surgical management, and outcomes. A case presentation demonstrates diagnostic, management, and treatment strategies and dilemmas encountered.Results: Nine patients were found to have infantile subglottic hemangiomas. Six of nine patients were treated with laser excision, with five of the six having localized subglottic hemangiomas. In 2009, three of four patients were initiated on propranolol as first-line treatment; the fourth had comorbidities which precluded this. Of t...

The complimentary role of diagnostic and therapeutic endoscopy in foreign body aspiration in children

International Journal of Pediatric Otorhinolaryngology — Tue, 01 Nov 2011 01:32:12 +0100

Conclusions: Rigid bronchoscopy under general anesthesia is an extremely accurate surgical technique to identify, localize and remove airway foreign body. In our experience, flexible bronchoscopy under total intravenous sedation and topical anesthesia is very useful in doubtful cases to absolutely exclude the presence of foreign body in upper airway tracheobronchial tree. (Source: International Journal of Pediatric Otorhinolaryngology)

Comparison of virtual bronchoscopy with fiberoptic bronchoscopy findings in patients exposed to sulfur mustard gas.

Acta Radiologica — Mon, 31 Oct 2011 04:00:00 +0100

ConclusionOur study indicates that VB is an accurate method for evaluating stenoses, endoluminal nodules, and poststenotic areas within the tracheobronchial tree of SM-exposed victims. This complementary method could be helpful in revealing hidden post-stenotic lesions and also better depict the long tracheal strictures and their actual length. PMID: 22042984 [PubMed - as supplied by publisher] (Source: Acta Radiologica)

Extubation of a difficult airway after thyroidectomy: use of a flexible bronchoscope via the LMA-Classic™

Canadian Journal of Anaesthesia — Sat, 29 Oct 2011 04:00:00 +0100

CONCLUSION: We describe a viable extubation strategy used in a patient after complex thyroid surgery involving tracheal resection. By using the LMA-Classic™ as a bridging device and to facilitate bronchoscopic examination, we were able to address the above concerns and safely manage the extubation phase in this patient. PMID: 22037986 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

The Contribution of Endobronchial Ultrasound-guided Forceps Biopsy in the Diagnostic Workup of Unexplained Mediastinal and Hilar Lymphadenopathy

Lung — Fri, 28 Oct 2011 17:17:31 +0100

Conclusion EBUS-guided forceps biopsy should be employed for the bronchoscopic diagnosis of intrathoracic lymphadenopathy of unknown etiology. Content Type Journal ArticlePages 1-6DOI 10.1007/s00408-011-9341-0Authors Karl-Josef Franke, Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Witten/Herdecke University, Ambrocker Weg 60, 58091 Hagen, GermanyChristiane Bruckner, Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Witten/Herdecke University, Ambrocker Weg 60, 58091 Hagen, GermanyMara Szyrach, ERBE Research, Waldhoernlestrasse 17, 72070 Tuebingen, GermanyKarl-Heinz Ruhle, Department of Pneumology and Critical Care Medicine, Helios Klinik Ambrock, Witten/Herdecke University, Ambrocker Weg 60, 58091 Hagen, Germany...

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Detachment of the carinal hook following endobronchial intubation with a double lumen tube

BMC Anesthesiology — Fri, 28 Oct 2011 04:00:00 +0100

Conclusion: Insertion of DLTs with carinal hook is associated with technical problems and potentially life-threatening hazards have discouraged their use. Fiberoptic evaluation and repositioning solves most of the problems. Although amputation of the carinal hook has not been previously reported, clinicians should be alert. This case report emphasizes the utility of the fiberoptic bronchoscopy in the operating theatre for placement, positioning and inspection of the carinal hook DLT. (Source: BMC Anesthesiology)

[The need of lung cancer screening - new evidence, new expectations.]

Pneumonologia i Alergologia Polska — Fri, 28 Oct 2011 02:15:02 +0100

Authors: Laprus I, Adamek M, Kozielski J Abstract Lung cancer is the most common cancer in Poland and in the world and the leading cause of cancer-related deaths. In the past 30 years lung cancer survival has not been improved. In the same period of time significant progress has been made in the results of treatment of many other cancers for example: breast, colorectal and prostate cancer. It may be connected with introduction of efficient screening tests. Lung cancer seems to be a disease for which screening could have great impact. In the 1970s trials evaluating chest roentgenograms and sputum cytology as screening modalities were conducted, but did not show reduction in lung cancer mortality. There have been several projects in which low-dose helical computed tomography was used...

Separation from Cardiopulmonary Bypass with a Rigid Bronchoscope Airway After Hemoptysis and Bronchial Impaction with Clot.

Anesthesia and Analgesia — Thu, 27 Oct 2011 04:00:00 +0100

We describe a unique case of hemoptysis resulting in bronchial impaction from a clot requiring an emergent return to CPB during valve replacement surgery. We used a rigid bronchoscope, without an endotracheal tube, to facilitate airway patency in a patient with diffuse airway bleeding after bronchial disimpaction to separate from CPB. PMID: 22034489 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Comparison of Hot Versus Cold Biopsy Forceps in the Diagnosis of Endobronchial Lesions.

Archivos de Bronconeumologia — Thu, 27 Oct 2011 04:00:00 +0100

CONCLUSIONS: Hot biopsy forceps significantly decreased the procedure related bleeding. The quality of samples was not impaired significantly. Regarding low prevalence of bleeding following endobronchial biopsy, routine use of hot bronchoscopy forceps is not reasonable. However, familiarity of bronchoscopists with this method may improve bronchoscopy safety. PMID: 22036191 [PubMed - as supplied by publisher] (Source: Archivos de Bronconeumologia)

Airway management in the patient with potential cervical spine instability: Continuing Professional Development.

Canadian Journal of Anaesthesia — Thu, 27 Oct 2011 04:00:00 +0100

CONCLUSION: Adequate airway management in the patient with potential C-spine injury demands an understanding of C-spine anatomy, the criteria required to clear the C-spine, and the indications, techniques, and pitfalls of C-spine immobilization. When choosing an airway technique, minimization of C-spine motion should be considered, but the method of choice should also incorporate the broader clinical context. PMID: 22033859 [PubMed - as supplied by publisher] (Source: Canadian Journal of Anaesthesia)

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Bronchoscopic closure of tracheoesophageal fistulas

Gastrointestinal Endoscopy — Wed, 26 Oct 2011 20:50:57 +0100

We want to congratulate Dr Repici and colleagues for their expertise in dealing with this difficult disease. The use of cardiac septal occluders for closure of airway fistulae has led to an ongoing trial of closure of tracheoesophageal fistulae at our institution. (Source: Gastrointestinal Endoscopy)

Bronchiectasis in chronic pulmonary aspiration: Risk factors and clinical implications

Pediatric Pulmonology — Tue, 25 Oct 2011 04:00:00 +0100

This study describes the prevalence, time course for development, and risk factors for bronchiectasis in children with CPA.Materials and MethodsUsing a cross‐sectional design, medical records were reviewed for all patients with swallow study or airway endoscopy‐confirmed aspiration in our airway center over a 21 month period. All patients underwent rigid and flexible bronchoscopy, and high resolution chest computed tomography. Prevalence, distribution, and risk factors for bronchiectasis were identified.ResultsOne hundred subjects age 6 months to 19 years were identified. Overall, 66% had bronchiectasis, including 51% of those less than 2 years old. The youngest was 8 months old. Severe neurological impairment (OR 9.45, P < 0.004) and history of gastroesophageal reflux (OR 3.36,...

Bridging therapy after recent stent implantation: case report and review of data

Cardiovascular Revascularization Medicine — Mon, 24 Oct 2011 04:00:00 +0100

Abstract: For patients requiring surgery within their first year following coronary stent placement, maximizing the prevention of stent thrombosis with antiplatelet therapy while minimizing the risk of intraoperative bleeding has become a management challenge for cardiologists, surgeons and anesthesiologists. In this manuscript, we describe a case of a patient who received three stents (two of which were drug-eluting) and 7 months later was bridged with intravenous eptifibatide, a short-acting glycoprotein (GP) IIb/IIIa inhibitor, for 3 days prior to bronchoscopy and cervical mediastinoscopy for a suspected lung cancer. We then review the current literature for data and guidelines describing the use of short-acting GP IIb/IIIa as bridge therapy. Finally, we provide recommendations, based o...

Anesthesia for tracheobronchial foreign bodies removal via self-retaining laryngoscopy and Hopkins telescopy in children

European Archives of Oto-Rhino-Laryngology — Fri, 21 Oct 2011 15:59:26 +0100

This study attempted to explore suitable anesthetic methods used for removal of tracheobronchial foreign body (FB) via self-retaining laryngoscopy and Hopkins telescopy in children. 92 cases had undergone FB removal via self-retaining laryngoscopy and Hopkins telescopy or rigid bronchoscopy in our hospital since 2006, of which 56 cases were under intravenous anesthesia and endotracheal intubation with muscle relaxation (IAEI with MR), and the other 36 cases were under intravenous anesthesia with spontaneous breathing (IASB). Operative parameters and intraoperative vital signs were analyzed. Tracheobronchial foreign body was successfully removed in 87 cases, and not found in the other 5 cases. SpO2 was below 90% transiently in 41 cases, 29 cases of which were under IAEI with MR and 12 ...

Clinical implication of pulmonary excision for undiagnosed peripheral lung cancer [Institutional report - Thoracic oncologic]

Interactive CardioVascular and Thoracic Surgery — Fri, 21 Oct 2011 04:00:00 +0100

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Feasibility of spray cryotherapy and balloon dilation for non-malignant strictures of the airway [Original articles]

European Journal of Cardio-Thoracic Surgery — Thu, 20 Oct 2011 04:00:00 +0100

Conclusions: Initial experience with SC for benign airway strictures suggests that this can be used safely. This is effective in improving symptoms and reducing the severity of airway narrowing. Re-intervention is still required. Further study should be undertaken to determine factors that may be associated with success or failure as well as the relative efficacy of SC compared with other endoscopic therapies. (Source: European Journal of Cardio-Thoracic Surgery)

Horseshoe lung associated with left lung hypoplasia and single left pulmonary vein; a rare combination

Clinical Radiology — Wed, 19 Oct 2011 04:00:00 +0100

Horseshoe lung (HL) is a rare bronchovascular anomaly in which the posterobasal segments of the right and left lung are fused with a narrow isthmus of pulmonary parenchyma in a common pleural space behind the heart and anterior to the aorta and oesophagus. HL is mostly associated with unilateral lung hypoplasia (most frequently the right lung) in conjunction with the Scimitar syndrome and is also associated with cardiovascular anomalies, such as atrial septal defects, ventricular septal defects, tetralogy of Fallot, and hypoplastic left ventricule. HL with left lung hypoplasia is extremely rare, with only a few cases reported in the literature. To the authors’ knowledge, this is the first case of HL associated with left lung hypoplasia and a single left pulmonary vein as depicted using m...

Classic Pulmonary Blastoma: A Subtype of Biphasic Pulmonary Blastoma.

Annals of Thoracic and Cardiovascular Surgery — Mon, 17 Oct 2011 04:00:00 +0100

We report a rare case of classic pulmonary blastema (CPB) without recurrence for 3 years after the operation. A 70-year-old man presented with cough and sputum for a month. Chest computed tomography (CT) showed a 5cm-sized mass in the right middle lobe. Bronchoscopic examination was performed, and the mass was suspected as adenocarcinoma of the lung. Right middle lobectomy and lymph node dissection were performed. The pathologic histology diagnosis was classic pulmonary blastoma, a subtype of biphasic pulmonary blastoma. PMID: 22001215 [PubMed - as supplied by publisher] (Source: Annals of Thoracic and Cardiovascular Surgery)

Pulmonary Resection for Mycobacterium Chelonae Infection.

Annals of Thoracic and Cardiovascular Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Authors: Goto T, Hamaguchi R, Maeshima A, Oyamada Y, Kato R Abstract Mycobacterium chelonae lung infection is rare and has long been recognized as an enigmatic infection resistant to medical therapy. Recently, we encountered a patient who underwent pulmonary resection for Mycobacterium chelonae infection. A 46-year-old man with no medical history was found to have an abnormal shadow in the left upper lung field on chest X-ray. Computed tomography showed a nodular shadow in the left upper lobe and disseminated shadows around it. Mycobacterium chelonae was detected from cultures of the sputum, bronchial washings, bronchoscopic biopsy specimens, and gastric fluid, and pulmonary infection with Mycobacterium chelonae was diagnosed. The shadow did not decrease in size despite antibiotic ...

MedWorm: Bronchoscopy

Bronchoscopy in Rural Areas?

Lung Separation in the Morbidly Obese Patient

[Correspondence] McCoy's syndrome: a new medical entity

Anesthetic Management of Direct Laryngoscopy and Dilatation of Subglottic Stenosis in a Patient with Severe Myasthenia Gravis

Endotracheal metastasis from basaloid squamous carcinoma of the esophagus

Lipid-Laden Alveolar Macrophages and pH Monitoring in Gastroesophageal Reflux-Related Respiratory Symptoms

Bronchoscopic Findings in Children With Chronic Wet Cough

Leiomyoma of the trachea.

Perioperative considerations in patients with Gitelman syndrome: a case series

Ergonomics in bronchoscopy: is there a need for better design or a change in the work environment?

Role of YKL-40 in Bronchial Smooth Muscle Remodeling in Asthma.

Does the use of extended criteria donors influence early and long-term results of lung transplantation?

Intrathoracic gossypiboma causing intractable cough

Leiomyoma of the Trachea [CASE REPORTS]

A National Survey of Airway Management Training in U.S. Internal Medicine-Based Critical Care Fellowship Programs.

Electromagnetic Navigation Bronchoscopy Performed by Thoracic Surgeons: One Center's Early Success.

Presentation of laryngeal papilloma in childhood: the Leeds experience

Lung adenocarcinoma with peculiar growth to the pulmonary artery and thrombus formation: Report of a case

Should bronchoscopy be advocated to study airway remodelling and inflammation in adults with cystic fibrosis?

Authors' response

The management of bronchus intermedius complications after lung transplantation: A retrospective study

Protandim(R) does not influence alveolar epithelial permeability or intrapulmonary oxidative stress in human subjects with alcohol use disorders.

CT Screening for Lung Cancer: Implication of Lung Biopsy Recommendations

Hiccups Induced by Midazolam During Sedation in Flexible Bronchoscopy.

Fiber-optic bronchoscope and detection of lung cancer: A five year study.

A Case of Endobronchial Aspergilloma Presenting as a Broncholith.

Questioning the legitimacy of rigid bronchoscopy as a tool for establishing the diagnosis of a bronchial foreign body

Evaluation of pediatric subglottic cysts

Year in review 2011: Respiratory infections, tuberculosis, pleural diseases, bronchoscopic intervention and imaging

Accuracy of Histological Classification of Needle Biopsy/Aspirate Specimens in Patients With Non-Small Cell Lung Cancer (NSCLC)

Minimally invasive bronchoscopic resection of benign tumors of the bronchi

Video-Assisted Thoracoscopic Lung Biopsy in the Diagnosis of Interstitial Lung Disease: A Prospective, Multi-Center Study in 224 Patients.

Endobronchial valve deployment in severe α‐1 antitrypsin deficiency emphysema: A case series

Atrial fibrillation after pulmonary lobectomy for lung cancer affects long-term survival in a prospective single-center study

Extracellular matrix in airway smooth muscle is associated with dynamics of airway function in asthma

Web-based versus traditional lecture: are they equally effective as a flexible bronchoscopy teaching method?

Turban pin aspiration: New fashion, new syndrome

Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient

Surgical treatment of right middle lobe syndrome in children

Descriptive data on cancerous lung lesions detected by auto-fluorescence bronchoscope: A five-year study

Fistula Formation Between the Right and Left Main Bronchus Caused by Endobronchial Tuberculosis.

A Fatal Case of Kaposi Sarcoma Due to Immune Reconstitution Inflammatory Syndrome.

Study of Efficacy of Anaesthesia With Propofol and Fentanyl for Rigid Bronchoscopy in Foreign Body Bronchus Removal in Children

Successful treatment of Nocardia pneumonia with cytomegalovirus retinitis coinfection in a renal transplant recipient

Endobronchial Ultrasound Plus Fluoroscopy Versus Fluoroscopy-Guided Bronchoscopy: A Comparison of Diagnostic Yields in Peripheral Pulmonary Lesions

Nodal stations and diagnostic performances of endobronchial ultrasound-guided transbronchial needle aspiration in patients with non-small cell lung cancer.

Accuracy of electromagnetic tracking with a prototype field generator in an interventional OR setting.

EXIT (Ex utero Intrapartum Treatment) in lymphatic malformations of the head and neck: Discussion of three cases and proposal of an EXIT-TTP (Team Time Procedure) list

Bronchoscopic thermal vapor ablation improves emphysema

FDA Targets Risks From Reused Medical Devices

Endobronchial Foreign Body Removed by Flexible Bronchoscopy Using the Trendelenburg Position

Prospective Randomised Trial of Ebus Guide Sheath Versus CT Guided Percutaneous Core Biopsies for Peripheral Lung Lesions

Endobronchial Foreign Body Removed by Flexible Bronchoscopy Using the Trendelenburg Position.

Deaths and complications associated with respiratory endoscopy: A survey by the Japan Society for Respiratory Endoscopy in 2010

Implantable coils improve COPD in pilot study

Initial results of the National Lung Cancer Screening Trial.

Lung cancer screening: rationale and background.

Airway remodeling and inflammation in competitive swimmers training in indoor chlorinated swimming pools

Matrix‐assisted laser desorption/ionization mass spectrometry reveals decreased calcylcin expression in small cell lung cancer

Lung Cancer following Bronchoscopic Lung Volume Reduction for Severe Emphysema: A Case and Its Management

Algorithm for Video Summarization of Bronchoscopy Procedures

Successful resection of a glomus tumor of the trachea

The clinical implications of bronchoscopy in hemoptysis patients with no explainable lesions in computed tomography

Endobronchial findings of hydatid cyst disease: A report of five pediatric cases

Pulmonary function and long‐term follow‐up of children with tracheobronchomalacia

Pneumocystis Pneumonia

An analysis of potential risk factors for early complications from fiberoptic bronchoscopy in lung transplant recipients

Diagnostic yield of bronchoscopic sampling in febrile neutropenic patients with pulmonary infiltrate and haematological disorders

Pulmonary Masses: Initial Results of Cone-beam CT Guidance with Needle Planning Software for Percutaneous Lung Biopsy

Endobronchial echinococcosis presenting as non‐resolving pneumonia

Tracheo-Bronchial Foreign Body Aspiration in Children: A One Year Descriptive Study

The presence of pepsin in the lung and its relationship to pathologic gastro‐esophageal reflux

Airway Ultraflex Stenting in Esophageal Cancer with Esophagorespiratory Fistula.

A New Tool for Extreme IVC Filter Removal

Anaesthetic equipment for thoracic surgery

Fibreoptic bronchoscopic positioning of double-lumen tubes

Limited short term steroid responsiveness is associated with thickening of bronchial basement membrane in severe asthma.

Perioperative management of a patient with a massive lipomatous mediastinal mass, severe cardiomyopathy, and tracheal stenosis for urgent laser bronchoscopy and stent placement

Bronchoscopic evaluation of the mediastinum using endobronchial ultrasound: a description of the first 216 cases carried out at an Australian tertiary hospital

Fiber-optic bronchoscope and detection of lung cancer: A five year study.

Endobronchial Hamartoma Removed Completely  by Bronchoscopic Electrosurgical Snaring: A Case Report