• Title/Summary/Keyword: Bronchial obstruction

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A Case of Endobronchial Hamartoma Treated with Rigid Bronchoscopy (경성 기관지내시경을 이용한 기관지내 과오종 치험 1예)

  • Kim, Ki-Hyun;Hong, Hyun-Suk;Koh, Eun-Suk;Koh, Yoon-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.24 no.1
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    • pp.83-87
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    • 2008
  • Hamartoma is one of the most common benign lung tumors. Most of them are located in the lung parenchyme, but very rarely it can originate endobronchially. Endobronchial hamartoma may cause irreversible lung damage due to the bronchial obstruction if it is not diagnosed and treated properly. The most frequent clinical features are hemoptysis and obstructive pneumonia. Transbronchial endoscopic surgery is a good therapeutic choice and is recommended first for patients who have resectable small endobronchial hamartoma. Here, we report a case of endobronchial hamartoma treated with rigid bronchoscopy and various microforceps with a review of the literature.

Primary Malignant Tracheal Tumor : 3 Cases (원발성 악성 기관 종양 3례)

  • 고중화;전영명;신상준;주희재
    • Korean Journal of Bronchoesophagology
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    • v.3 no.1
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    • pp.137-147
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    • 1997
  • The rarity of primary tumor of the trachea, which was recently estimated in a circumscribed population to be 2.7 new cases per million per year, explains the relatively limited experience that has been acquired even by major institutions. Although there may already by a high degree of airway obstruction, tracheal tumors are usually misdiagnosed as bronchial asthma or chronic bronchitis because of its nonspecific symptoms. Surgery is the treatment of choice. Recently, the authors experienced three cases of primary tracheal malignant tumors ; one case of mucoepidermoid carcinoma and two cases of adenoid cystic carcinoma. The authors report on these cases with a review of the literature for give help in differential diagnosis and treatment planing of tracheal tumor.

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The Correlation between Bronchostenosis and Changes in the Levels of Interferon-γ and Transforming Growth Factor-β during the Treatment in patients with Endobronchial Tuberculosis (기관지 결핵 치료 후의 기관지 협착 발생과 Interferon-γ 및 Transforming Growth Factor-β 농도 변화의 연관성)

  • Kim, Ki Uk;Lee, Su Jin;Lee, Jae Hyung;Cho, Woo Hyun;Jung, Kyung Sik;Joe, Jin Hoon;Kim, Yun Seong;Lee, Min Ki;Kim, Yeong Dae;Choi, Young Min;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.1
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    • pp.18-24
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    • 2005
  • Background : Endobronchial tuberculosis often complicates bronchostenosis, which can cause dyspnea due to an airway obstruction, and can be misdiagnosed as bronchial asthma or lung cancer. This study investigated the possible correlation between the $interferon-{\gamma}$($IFN-{\gamma}$) and transforming growth $factor-{\beta}$($TGF-{\beta}$) levels in the serum and bronchial washing fluid and the treatment results in endobronchial tuberculosis patients. Methods : Sixteen patients, who were diagnosed as endobronchial tuberculosis using bronchoscopy, and 10 healthy control subjects were enrolled in this study. The $IFN-{\gamma}$ and $TGF-{\beta}$ levels were measured in the serum and bronchial washing fluid of 16 endobronchial tuberculosis patients before and after treatment using the ELISA method. The endobronchial tuberculosis patients were divided into those who showed bronchial fibrostenosis after treatment and those who did not. Results : The $IFN-{\gamma}$ and $TGF-{\beta}$ levels in the bronchial washing fluid in endobronchial tuberculosis patients were elevated comparing to the control (p<0.05). After treatment, 7 of the 16 endobronchial tuberculosis patients showed bronchial fibrostenosis and the other 9 cases healed without this sequela. In the patients with fibrostenosis after treatment, the initial serum $TGF-{\beta}$ level was lower than the patients without fibrostenosis after treatment (p<0.05). Moreover, the serum $TGF-{\beta}$ level after treatment further decreased comparing to the patients without fibrostenosis after treatment(p<0.05). Conclusion : Elevated $IFN-{\gamma}$ and $TGF-{\beta}$ levels in the bronchial washing fluid in endobronchial tuberculosis patients are believed to be related to the pathogenesis of endobronchial tuberculosis. The decreased initial serum $TGF-{\beta}$ level and the change in the serum $TGF-{\beta}$ level after treatment are believed to be involved in bronchial fibrostenosis during the course of the disease.

Clinical Significance of Airway Resistance Curve by the Body Plethysmograph (Body Plethysmograph를 이용한 Airway Resistance Curve의 임상적 의의)

  • Cheon, Seon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.218-225
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    • 1995
  • Background: Airway resistance(Raw) is measured with the body plethysmograph by displaying the relationship between airflow and alveolar pressure($V/P_A$). If the resistance curve on $V/P_A$ tracing is curved or looped, the estimation of Raw is difficult. This study was designed to examine wheather there is any correlation between the shape of resistance curve and the clinical status and the pulmonary function of patients. Methods: The 146 pulmonary disease patients with increased Raw were included in this study. The shapes of resistance curves on $V/P_A$ tracing with body plethysmograph during quiet breathing were analyzed and compared with pulmonary function. Results: The results were as follows ; 1) The shapes of resistance curves were summarized in 5 categories; type 1: linear, type 2: ovoid, type 3: sigmoid, type 4: scoop, type 5: paisley. The type 3 except 1 case, type 4 and type 5 were found to have loop mainly in expiratory phase. 2) Although the shapes of resistance curves were not typical for specific disease, the resistance curves of acute disease tended to belong to type 1 or 2 and those of chronic airflow obstruction tended to belong to type 3, 4 or 5. But resistance curves of bronchial asthma and destructive lung with tuberculosis showed all types in proportion to degree of airflow obstruction or destruction of parenchyme. 3) In the cases of resistance curves going to type 5 rather than type 1 and those with looping, airflow obstuction tended to be severe and airway resistance and residual volume tended to increase. Conclusions: Analysis of resistance curve on $V/P_A$ tracing measuring airway resistance is helpful for judging degree of airflow obstruction and air trapping. Although the shape of resistance curve is not typical for specific disease, there is a close association between looping and airway obstruction.

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Massive Hemoptysis Cases Intubated with the Univent$^{(R)}$ Bronchial Blocker for Lung Protection (건측 폐보호를 위해 Univent$^{(R)}$튜브를 사용한 대량객혈환자의 증례)

  • Moon, Jae-Young;Lee, Young-Seok;Lyu, Ji-Won;Huh, Jin-Won;Hong, Sang-Bum;Kim, Sang-We;Lim, Chae-Man;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.212-217
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    • 2012
  • Massive hemoptysis is a life-threatening condition and sometimes leads to death due to airway obstruction rather than exsanguinations. In a critical hemoptysis, endotracheal intubation may be necessary to maintain adequate gas exchange and protect the unaffected side of the lung. Bronchial blockers (BBs), commonly used technique for one-lung ventilation in thoracic or cardiac surgeries, are valuable devices for protecting the airway in massive endobronchial bleeding. We report three cases intubated with BBs, Univent$^{(R)}$, in massive hemoptysis. We suggest that BBs are one of the indispensable equipments for respiratory specialized wards and intensive care units.

Cigarette Smoke Extract-induced Reduction in Migration and Contraction in Normal Human Bronchial Smooth Muscle Cells

  • Yoon, Chul-Ho;Park, Hye-Jin;Cho, Young-Woo;Kim, Eun-Jin;Lee, Jong-Deog;Kang, Kee-Ryeon;Han, Jae-Hee;Kang, Da-Won
    • The Korean Journal of Physiology and Pharmacology
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    • v.15 no.6
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    • pp.397-403
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    • 2011
  • The proliferation, migration, cytokine release, and contraction of airway smooth muscle cells are key events in the airway remodeling process that occur in lung disease such as asthma, chronic obstruction pulmonary disease, and cancer. These events can be modulated by a number of factors, including cigarette smoke extract (CSE). CSE-induced alterations in the viability, migration, and contractile abilities of normal human airway cells remain unclear. This study investigated the effect of CSE on cell viability, migration, tumor necrosis factor (TNF)-${\alpha}$ secretion, and contraction in normal human bronchial smooth muscle cells (HBSMCs). Treatment of HBSMCs with 10% CSE induced cell death, and the death was accompanied by the generation of reactive oxygen species (ROS). CSE-induced cell death was reduced by N-acetyl-l-cysteine (NAC), an ROS scavenger. In addition, CSE reduced the migration ability of HBSMCs by 75%. The combination of NAC with CSE blocked the CSE-induced reduction of cell migration. However, CSE had no effect on TNF-${\alpha}$ secretion and NF-${\kappa}B$ activation. CSE induced an increase in intracellular $Ca^{2+}$ concentration in 64% of HBSMCs. CSE reduced the contractile ability of HBSMCs, and the ability was enhanced by NAC treatment. These results demonstrate that CSE treatment induces cell death and reduces migration and contraction by increasing ROS generation in normal HBSMCs. These results suggest that CSE may induce airway change through cell death and reduction in migration and contraction of normal HBSMCs.

Endobronchial Leiomyoma - A case report - (기관지내 평활근종 -1례 보고-)

  • 김한용;황상원;이연재;유병하;안종운;김병헌
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.725-729
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    • 1998
  • Endobronchial leiomyoma is extremely rare and accounts for less than 2% of benign tumors of the lower respiratory tract. Leiomyomas are predominantly found in the young and the middle aged : of the average age being 35 years for bronchial and lung parenchymal lesions and 40.6 years for tracheal lesions. The symptom depends on the location of the tumor, its size, and changes in the lung distal to the lesion. A 37-year-old woman was admitted to our hospital complaining of coughing. Bronchoscopy revealed complete obstruction of the right main bonchus at the carina by an oval-shaped, nonulcerative, smooth, and pinkish-tan tumor with a broad margin and extended to the left main bronchus. A biopsy was performed and showed a benign spindle cell tumor. A right pneumonectomy was performed because of chronic infection, and the lung could not expanded during aeration. The histological diagnosis of the resected specimen was leiomyoma. The postoperative course was uneventful.

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A Case of Broncholithiasis Caused by Aspergillus (Aspergillus에 의한 기관지 결석증 1예)

  • Kwon, Mi-Young;Oh, Yoon-Ju;Ryu, Jeong-Seon;Kwak, Seung-Min;Lee, Hong-Lyeol;Cho, Chul-Ho;Roh, Hyung-Keun;Kim, Joon-Mee
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.1
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    • pp.136-141
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    • 1999
  • Broncholith is a calcified lymph node which partially or completely erodes into the bronchial lumen and broncholithiasis is a relatively rare condition which related to late tissue response to healing granulomatous pulmonary infections, most commonly histoplasmosis or tuberculosis. The prominent symptoms of broncholithiasis are coughing followed by hemoptysis and symptoms related to bronchial obstruction. The complications include bronchoesophageal fistula and aortotracheal fistula. We report one case of broncholithiasis caused by Aspergillus. The case was a 53 year-old house wife whose chief complaints were recurrent fever, chill and malaise. The chest film revealed an avoid hazziness on the right middle lobe and chest cr scan showed consolidation of lateral segment of right middle lobe with calcified small low attenuated lesion in right middle lobe bronchus. Aspergillosis confirmed by pathology after bronchoscopic removal of impacted Aspergillus containing muddy plug from lateral segmental branch of right middle lobe bronchus.

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A Case of Endobronchial Chondroma (좌측 주기관지에 발생한 연골종 1예)

  • Kim, Young-A;Jung, Jae-Han;Chang, Yoon-Soo;Kim, Hyung-Jung;Ahn, Chul-Min;Cho, Sang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.1
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    • pp.78-83
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    • 2000
  • Endobronchial chondroma is a cartilaginous benign tumor, which arises from bronchial cartilage. As a rare benign tumor, endobronchial chondroma differs from cartilaginous hamartoma in that it includes cartilage components only, but hamartoma contains lipomatous and lymphoid tissue. The clinical manifestations of endobronchial chondroma are associated with the extent of mechanical obstruction of bronchus. Symptoms of endobronchial chondroma are nonspecific, such as cough, sputum, fever, or dyspnea on exertion. Endobronchial chondroma is often misdiagnosed as other diseases, such as asthma, chronic obstructive pulmonary disease, or pulmonary tuberculosis. The treatment is usually surgical procedures, such as resection of lung segment or lobe by thoracostomy, or resection of tumor by bronchoscopy. We report a case of the patient who was diagnosed to have endobronchial chondroma treated by bronchial resection and end to end anastomosis.

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Clinical Relevance of Bronchial Anthracofibrosis in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

  • Kim, Hyera;Cha, Seung-Ick;Shin, Kyung-Min;Lim, Jae-Kwang;Oh, Serim;Kim, Min Jung;Lee, Yong Dae;Kim, Miyoung;Lee, Jaehee;Kim, Chang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.124-131
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    • 2014
  • Background: Bronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance. Methods: A total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups. Results: Patients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group. Conclusion: Compared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.