Bronchoscopy

To assess the potential role of multiple bronchoalveolar lavages (BALs) in the treatment of children with lipoid pneumonia (LP). This prospective study included 10 children (7 female, 3 male) with LP secondary to mineral oil aspiration. The age ranged from 3 months to 7 years and 1-60 days history of mineral oil intake, with a 6 months clinic follow-up. High-resolution computer tomography (CT) was performed 1-7 days prior to treatment and 2-20 days after the last therapeutic BAL, and reviewed by two experienced chest radiologists. Oxygen saturation was measured with digital oximetry. Therapeutic BAL was performed weekly until BAL fluid was nearly transparent and the cell count returned to normal range values. In all children, the initial CT scans showed multifocal bilateral consolidation involving mainly the dorsal and central regions. The areas of consolidation had foci of decreased attenuation in eight patients. Following a total of 4-10 therapeutic BALs, the CT scans returned to normal in 3 patients, improved considerably in 5, and showed only slight improvement in 2. Oxygen saturation increased from 88.8 +/- 3.4% at presentation to 96.2 +/- 0.8% after treatment (P < 0.0001). Multiple lavages reduced (P < 0.003) numbers of lipid-laden macrophages and restored BAL cellularity to normal range values. Multiple therapeutic BAL of children with LP results in significant improvement of CT findings, oxygen saturation, restoration of BAL fluid cellularity and clinical recover without any evidence of respiratory distress at the end of treatment and 6 months after the last BAL.

Background: The increase of basement membrane thickness (BMAT) represents a structural feature described as commonly characterizing airway remodelling in asthma, even if the non-atopic condition had been investigated only episodically from this point of view. Gastrooesophageal-reflux is a pathological condition which can frequently cause and/or sustain asthma in non-atopic individuals. Objectives: The aim of the study was to measure BMT; some inflammatory mediators in BAL; cys-leucotrienes (LTE4) in urine; e-NO, and BHR to Methacholine (MCh) in mild atopic and in mild non-atopic, GER-related asthma. Methods: After their informed consent, 25 mild atopic (40.9 years +/- 13.1 sd, FEV1 = 95.9% pred. +/- 12.9 sd) and 39 non-atopic, GER-related asthmatics (57.3 years +/- 14.2 ds, FEVY1 = 101.3% pred. +/- 12.2 sd), nonsmoker and of a comparable asthma duration, underwent measurements of basal lung function and bronchial response to MCh (PD20 FEV1); endobronchial biopsies and BAL (in the right middle lobe), and a 24-h gastroesophageal pHmetry. Results: Atopic GER-related asthma showed two distinct patterns of airway inflammation. The eosinophilic contribution to airway inflammation was systematically prevailing in the former group, such as: EOS = 10.7% +/- 13.4 sd vs 2.0% +/- 2.8 sd, p = 0.001; ECP = 344.9 mcg/l +/- 635.9 sd vs 59.2 mcg/l +/- 75.1 sd, p = 0.001. Conclusions: Data from the present study are suggesting that persistent mild atopic and mild GER-related asthma seem to represent two distinct phenotypes of asthma in terms of airway remodelling, and in particular of BMT involvement.

Background: Foreign bodies can come from outside the body (exogenous) and in the body (endogenous). Foreign bodies can cause total obstruction resulting in atelectasis or partial obstruction with emphysema. Case: A 14-year-old girl with a cough with phlegm mixed with blood spots one day before admission. Patients swallowed needle 10 days ago while wearing jilbab while joking at school. Chest X-rays appear density of a metal with a long straight form of about 3.5 cm projected in the lower right hemitorac. Discussion: Performed Fiber Optic Bronchoscopy (FOB) with diagnostic and therapeutic indications for picking up foreign objects. In patients there is minimal bleeding post extraction pentul needle. Bleeding can be overcome by administering a cold sterile NaCl solution to the airway. Thoracotomy is not performed on the patient because the needle can be taken using FOB. Conclusion: Foreign bodies of the airways can be harmful. The needle extraction using FOB can rule out the need for thoracotomy in patients.

CT bronchus sign (BS) designates a bronchus leading directly to a peripheral pulmonary lesion. The objective of this investigation is to determine the contribution of BS-guided bronchoscopic multiple diagnostic procedures (BMDPs) to the diagnostic yield of solitary nodules or masses (SPNMs) suspected of pulmonary carcinoma (PC). A prospective study was carried out in 92 patients with a 2–5 cm diameter

To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings. A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most common...

Nous rapportons l’observation d’un homme de 68 ans qui avait consulté pour dyspnée et hémoptysie. La fibroscopie bronchique avait montré une formation bourgeonnante au niveau du versant postérieur de la carène. Des biopsies bronchiques étagées étaient réalisées et avaient conclu à une amylose de type AL. L’amylose trachéobronchique localisée est une affection très rare, pouvant simuler une tumeur bronchique surtout lorsqu’elle survient chez un sujet de sexe masculin et tabagique.The authors report the case of a 68-year-old man complaining of haemoptysis and breathlessness. Bronchoscopy revealed a budding formation in tracheal bifurcation. Multiple biopsies were performed and concluded as to AL type amyloidosis. Tracheobronchial amyloidosis is an uncommon localised form of amyloidosis that can simulate lung cancer.

... Other chest surgeons in Tehran were Dr. Amir Mansoor Roushan-Zamir (b. 1930), Dr. Davood Kazemi, Dr. Sarkis Sarkisian, and Dr. Jahangir Mir Ala (d. 1971). Dr. Farrokh Saidi (b. 1930) is an American-trained cardiothoracic surgeon (Figure 5). He started his work at the ...

We describe a 46-year-old splenectomized patient who died of Haemophilus influenzae septicemia 16 h following bronchoscopy. Although rare, postsplenectomy overwhelming sepsis is always a danger in splenectomized patients undergoing invasive procedures. Chemoprophylaxis should be considered in asplenic patients peribronchoscopy.