• Korean Journal of Bronchoesophagology
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• v.3 no.2
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• pp.313-317
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• 1997

Airway mucus provides the protective functions such as lubrication, barrier, disposal of trapped materials, and humidification. In the normal state, the mucus do not interfere with Bas transport and the other vital functions of lung. In diseases such as asthma, bronchitis, and cystic fibrosis, the mucus hypersecretion was physiologically developed in the response of multiple neurohumoral mechanism system. And regardless of the mechanism, many clinical sequelae result from mucus hypersecretion: atelectasis, infection, increased airway resistance, increased work of breathing, increased cough with its resultant complication. And the condensation of mucus tv mucus hypersecretion can make the mucus plug by which bronchial obstruction is developed. We have experienced a 7 Pear-old male patient with recurrent pneumonic symtom, which the bronchial obstruction was developed by the impacted mucus plug on the bronchoscopic finding. We report this case with the review of literature.

• Tuberculosis and Respiratory Diseases
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• v.66 no.3
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• pp.216-219
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• 2009

A bronchial obstruction of the remaining lung is a rare complication of thoracic surgery. We report a case of this rare complication after a right upper lobectomy due to a giant bulla. Post-resectional angulation of the bronchus intermedius caused the bronchial obstruction. An intrabronchial stent was inserted into the bronchus intermedius, which relieved the obstruction.

• Journal of Chest Surgery
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• v.9 no.1
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• pp.27-37
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• 1976

In the presence of clinical evidence and chest roentgenogram suggestive of bronchogenic carcinoma, reliance is almost wholly placed on Papanicolaou staining of the sputum, bronchoscopy, and biopsy of peripheral lesion, together referred to as the "diagnostic triad". However, bronchography remains relatively non-utilized. Our experience with 56 bronchograms in which the modality of bronchial obstruction, distance to obstruction and reduction rate of caliber in leading bronchus were used in an attempt to explain underlying chest pathology and operability of bronchogenic carcinoma, indicated as follows: 1. The bronchographic findings in bronchogenic cancer consist of malignant bronchial obstruction in which the modality of obstruction is classified as abrupt type, conical type and compressed type in incidence of 50.0%, 23.2% and 26.8%, respectively. 2. Abrupt type of bronchial obstruction is more common in hilar type and particularly in squamous cell and undifferentiated cell type of bronchogenic cancer. In this type of obstruction the inoperability revealed in 57.8% and resectability in 17.8%. 3. Conical type of obstruction was a sign of most malignancy, in which 61.5% was undifferentiated cell type and 38.4% was squamous cell type. All this type of obstruction was inoperable even feasibility was presumed in simple roentgenograms. 4. Compressed type of obstruction was more common in peripheral type of bronchogenic cancer and showed 50.0% of resectability. 5. The distance from carina to bronchial obstuction revealed average 3.8cm in undifferentiated type, 5.76cm in squamous cell type and 7.60am in adeno cell type of carcinoma. 6. The reduction rate of caliber in leading bronchus to obstruction (mm per unit cm lenghth of leading bronchus) revealed average 2.15mm/cm in undifferentiated type 1.90mm/cm in squamous cell type and 1.13mm/cm in adeno cell type of carcnoma. 7. The reduction rate of caliber in leading bronchus showed 2.14mm/cm in inoperable cases and 1.42mm/cm in resectable cases. 8. The modality of bronchial obstruction and estimation of the reduction rate of caliber seemed to be a most reliable key-point to decide feasibility of resection.

• Journal of Chest Surgery
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• v.29 no.12
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• pp.1366-1372
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• 1996

Bronchoplasty has gained popularity in the selected cAses of bronchogenic carcinoma with poor pulmonary reserve, and also has been a choice of treatment for obstructive bronchial diseases since it can cure patient completely with preservation of pulmonary function. From Apr. 1990 to hpr. 19'96 two methods of bronchoplastic procedures, d patch dilating bronchoplasty and a segmental bronchial resection with end-to-end anastomosis, were performed with or without concominant pulmonary resection in 13 patients with benign bronchial stenosis and obstruction. The patients were 8 men and 5 women with average age of 43years(range 19 to 64 years). Patch dilating bronchoplasty using autogenous perichondrium and pericardium was applied in 5 cases of bronchial stenosis. Antecedan diseases of bronchial stenosls were 3 inflammatory bronchiectas is, and 2 endobronchial tuberculose is mixed with bronchi,ectas is. Segmental bronchial resection with end-to-end anastomosis was applied in 8 cases of bronchial obstruction, which were caused by endobronchial tuberculosis in 6 and cicatrization after trauma and foreign body in one case each. Bronchial obstructive symptoms and signs including recurrent pulmonary infection, dyspnea and wheezing were disappeared postoperatively with satisfactory recovery of physical activity. There was no operative mortality. Morbidity occured in 2 patients which were one case of unstability of applied bronchial patch resulting atelectasis and one case of bronchial restenosis at the anastomotic site. Based upon our experiences, we conclude that bronchoplastic procedure can be done with great success in patients with lung atelectasis caused by bronchial obstruction or stenosis and it restores physiologic function of collapsed lung with acc ptable complication.

• The Korean Journal of Nuclear Medicine
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• v.29 no.3
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• pp.307-312
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• 1995

The present study has been carried out to assess the diagnostic usefulness of radioaerosol lung scan in complete bronchial obstruction (n=7) and bronchial narrowing (n=1) of varying causes. $^{99m}Tc$-phytate lung scan was performed using the aerosol generated by a BARC nebulizer. Scan alterations were correlated with those of chest radiography, bronchography, lung CT and/or brochoscopy. In every case scan showed characteristic intense deposition of radioaerosol in a short slightly dilated, bronchial segment immediately proximal to obstruction or stenosis. Characteristically it was accompanied by an airspace aerosol deposition defect distally. The finding of a short, clubbed, bronchial radioaerosol deposition with distal airspace defect is a sensitive, specific indicator of bronchial obstruction or stenosis. It was especially useful in the detection of the obstruction of a small bronchus at the lobar and sublobar levels. We propose to name it the prestenotic aerosol deposition sign.

• Tuberculosis and Respiratory Diseases
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• v.38 no.4
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• pp.347-356
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• 1991

Endobronchial tuberculosis is a serious disase because it frequently leaves airway obstruction as the complication, and the treatment of airway obstruction is generally troublesome. In the tumorous type of endobonchial tuberculosis, the bronchial patency is partially or completely compromised with lymph node contents when the necrotic focus of the lymph node ruptures into the bronchial lumen to form a bronchoglandular fistula. To investigate the transition of endobronchial lesion and to evaluate the therapeutic role of bronchoscopic electrocautery in the tumorous type of endobronchial tuberculosis, we performed electrocautery in addition to the combination chemotherapy with steroid and anti-tuberculous drugs in two cases which had airway obstruction proximal to lobar bronchus with the impairment of pulmonary function. We also treated another two cases only with chemotherapy and we have followed up four cases over a 36-month period. In cases that bronchoscopic electrocautery was done, the bronchial patency was completely restored and the impairment of pulmonary function disappeared just after cautery and these effects have remained for 12 months or more. But in cases of medical treatment only, bronchial stenosis was inevitable as the tumorous type of endobronchial tuberculosis changed to the stenotic type with fibrosis. It can be concluded that bronchoscopic electrocautery can nip the occurence of bronchial stenosis in the bud when it is applied in addition to combination chemotherapy with steroid and antituberculous drugs in the tumorous type of endobronchial tuberculosis.

• Journal of Chest Surgery
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• v.27 no.11
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• pp.957-960
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• 1994

The endobronchial hamartoma is a relatively rare benign tumor of the lung. The symptoms of the endobronchial hamartoma are produced by obstruction of the bronchus and its sequelae. This patient was 51 year old male and complained dypnea, cough and purulent sputum for 2 years. On bronchoscopic view, a yellowish pedunculated mass nearly total occluding right main bronchial lumen was found. Endoscopic biopsy revealed squamous cell metaplasia of the bronchial mucosa. The operation was done with the right pneumonectomy. The pathologic result of the operative specimen was endobronchial hamartoma arisen from the right upper lobe bronchus.

• Journal of Chest Surgery
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• v.19 no.3
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• pp.484-488
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• 1986

Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

• Tuberculosis and Respiratory Diseases
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• v.45 no.2
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• pp.416-420
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• 1998

Flow-volume loop is known to be useful in the diagnosis of upper airway obstruction. In cases of tracheal obstruction, characteristic features such as fixed or variable upper airway obstruction patterns give clue to the diagnosis. But the flow-volume loop of unilateral mainstem bronchial stenosis is not known well. There is controversy in patterns of flow-volume loop in unilateral mainstem bronchial stenosis (restrictive pattern or biphasic pattern). We report a case of biphasic flow-volume loop in left mainstem bronchial stenosis(4-5 mm in diameter) as a sequela of endobronchial tuberculosis, which recovered normal flow-volume loop after metallic stent insertion and 2 months later showed reappearance of biphasic pattern because of restenosis of left mainstem bronchus due to growth of granulation tissue at the stent site.

• Journal of Chest Surgery
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• v.28 no.2
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• pp.201-205
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• 1995

Most of the patient with endobronchial tuberculosis have some degree of bronchial stenosis. however, a part of bronchial stenosis need aggressive treatment for the patency because of severe symptoms. The self-expendable metallic stents provide palliative treatment for narrowed airways where surgical resection is inadvisable. We experienced a successful left wedge pneumonectomy on a 29-year-old woman with obstruction of left main bronchus due to complication of the bronchial stent. She had inserted self-expendable metallic stents on left main bronchus of the tuberculous bronchial stenosis two times. There was no specific postoperative complication.