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At least 19 recordsLinked to original sources
PubMed1992

Contamination of flexible fiberoptic bronchoscopes with Mycobacterium chelonae linked to an automated bronchoscope disinfection machine.

Between December 5, 1989, and September 25, 1990, Mycobacterium chelonae was isolated from endoscopic or bronchial washings in 14 patients on a single clinical service. A phenotypically unique strain of M. chelonae subspecies abscessus that was highly resistant to cefoxitin (MIC greater than 256 micrograms/ml) and different from 13 control isolates of M. chelonae recovered elsewhere in the hospital was identified in all these patients and the rinse water from the bronchoscope disinfecting machine. None of the outbreak patients had evidence of invasive M. chelonae disease. Aggressive infection control measures on the disinfecting machine, including use of sterile water in the wash and rinse cycles, increasing the 2% alkaline glutaraldehyde exposure time, frequent replacement of the glutaraldehyde, and disinfection of the machine, failed to eradicate the M. chelonae, presumably because of the presence of a biofilm inside the machine. Rinsing the scopes with 70% alcohol after automated disinfection eliminated the outbreak strain. This study demonstrates that automated bronchoscope disinfecting machines may become heavily contaminated with mycobacteria that resist usual disinfection, resulting in a source of bronchoscope contamination.

Bronchoscopes↗
PubMed1992

Diagnostic correlation of fiberoptic bronchoscopic biopsy and bronchoscopic cytology performed simultaneously.

The reliability of bronchoscopic cytology relative to biopsy is controversial. Some still consider biopsy the definitive procedure. Comparative studies are few and limited in scope. Therefore, we compared simultaneously obtained biopsies and cytologies for 224 cases. One hundred and sixty-six cases (74.6%) correlated completely. Forty-four cases (19.6%) did not correlate and cytology was diagnostic in 24 of these. Biopsy was diagnostic in sarcoidosis and vasculitis, whereas cytology only excluded the presence of neoplasm or infection. In 14 cases (5.8%), biopsy and cytology showed pathologic changes, but one or the other was more definitive. Rarely, the 2 techniques provided complementary information. A specific diagnosis was obtained more often from the combination of cytology and biopsy than from either alone. However, when biopsy is contraindicated it is reassuring that cytology usually yields the same information as biopsy, and can detect neoplastic and infectious diseases when the biopsy is non-diagnostic.

Biopsy↗
PubMed1992

Accuracy of the bronchoscopic DNA content analysis of non-small-cell lung carcinoma.

To assess the accuracy of the bronchoscopic DNA content analysis, samples of non-small-cell lung carcinomas (NSCLC) were investigated by means of flow cytometry. Samples were dissociated using the detergent Triton X-100. In 58 NSCLC cases, 39 (67%) had DNA aneuploid tumors. We compared the DNA indices of bronchoscopic brushing samples with 21 corresponding surgical samples. In 16 (76%) cases, DNA ploidy of both bronchoscopic and surgical samples were in concordance. In 3 (14%) cases, both bronchoscopic and surgical sample showed DNA aneuploidy, but the number of the DNA aneuploid stem cell lines was different. The cause of these differences was ascribed to the intratumor DNA heterogeneity. In 2 (10%) cases, the bronchoscopic sample showed DNA diploidy, but the surgical sample showed DNA aneuploidy. In these cases, tumor cells obtained by bronchoscopic brushing were so few that the small DNA aneuploid peak was undetectable in the DNA histogram. But the tumor DNA ploidy was evaluated correctly in 90% of 21 cases using bronchoscopic samples. Consequently, despite some drawbacks, the DNA ploidy diagnosis using bronchoscopic samples in this relatively small study, was almost as reliable as surgical samples.

Adenocarcinoma↗
PubMed1979

Respiratory acidosis with the small Storz-Hopkins bronchoscopes: occurrence and management.

Carbon dioxide retention in the Storz rigid ventilating bronchoscope with the Hopkins lens system was investigated in the laboratory. The 3.5, 4.0, and 5.0 30-cm Storz bronchoscopes with a 3.95-mm (outside diameter) telescope lens were used in 10 mongrel dogs weighing between 8 and 15 kg. Significant (p less than 0.01) accumulation of arterial carbon dioxide tension (PaCO2) (respiratory acidosis) was observed after 5 and 10 minutes of ventilation through the 3.5 and 4.0 bronchoscopes, but no significant increase in PaCO2 was noted with the 5.0 bronchoscope. There was no significant change in arterial oxygen tension under the same conditions. Manual compression of the upper anterior abdominal wall during expiration was applied during bronchoscopy in 6 children. Arterial blood samples were taken before insertion of the bronchoscope and 5 minutes later with and without abdominal compression during expiration. A significant increase (p less than 0.05) in PaCO2 and a decrease in pH were observed after 5 minutes of the bronchoscopic procedure without manual compression of the abdominal wall, while no significant changes in PaCO2 were observed with abdominal compression.

Abdominal Muscles↗
PubMed1992

Sputum cytology-positive, bronchoscopically negative adenocarcinoma of the lung.

Among a total of 114 cases of resected lung adenocarcinoma that were examined by sputum cytologic study before bronchoscopy, 17 were sputum cytology-positive, but had no abnormal bronchoscopic findings. In most of these cases, the reason for detection was sputum and bloody sputum (58.8 percent). Pathologically, many cases were classified as stage III A or more (82.4 percent) due to mediastinal lymph node metastases. More than 70 percent of the cases showed vascular invasion. The proportion of well-differentiated cases was also high (52.9 percent). The prognosis of these cases was worse than sputum cytology-negative adenocarcinoma without abnormal bronchoscopic findings and better than sputum cytology-positive adenocarcinoma with abnormal bronchoscopic findings. There was no significant difference between these cases and sputum cytology-negative adenocarcinoma with abnormal bronchoscopic findings. Combined with the bronchoscopic findings, sputum cytologic study is useful for preoperative evaluation of lymph node metastasis and prognosis. This combined approach can provide information necessary to perform sufficient dissection of mediastinal lymph nodes and proper adjuvant therapy in sputum cytology-positive adenocarcinoma cases, even though there are no abnormal bronchoscopic findings.

Adenocarcinoma↗
PubMed1977

Contamination of a fiberoptic bronchoscope with Proteus species.

We have traced an episode of contamination of a fiberoptic bronchoscope with a Proteus species to an index patient. Bacterial cultures obtained by aspiration through the fiberoptic bronchoscope from 11 of 12 subsequent bronchoscopies in 8 additional patients grew a Proteus species with sensitivities similar to those of the initial isolate. Culture of the fiberoptic bronchoscopic specimen yielded an identical organism. There were no definitive ill effects in the patients. These findings necessitated a change in our fiberoptic bronchoscope disinfection protocol as well as development of culture surveillance mechanism to detect breaks in the cleaning procedure. The importance of this and avoiding potential outbreaks of fiberoptic bronchoscope-related infeciton is emphasized.

Bronchoscopes↗
PubMed1992

The flexible fiberoptic bronchoscopic shuttle.

The purpose of this paper is to describe a novel and practical technique for endobronchial catheter placement utilizing the flexible fiberoptic bronchoscope. Placement of endobronchial catheters via the flexible bronchoscope is limited by the small dimension of the bronchoscope's internal channel and frequently requires repeated manipulation to verify position endobronchially. We describe preliminary experience with a technique that we call the "bronchoscopic shuttle," which circumvents this limitation. The spectrum of possible clinical uses for this technique is discussed.

Brachytherapy↗
PubMed1978

[Advantages of blood gas analyses of an improved ventilation bronchoscope (author's transl)].

During bronchoscopy in elder patients the development of respiratory acidosis is a hazard. A new and improved ventilation bronchoscope decreases the risk, which was demonstrated by blood gas analyses. This bronchoscope differs from those normally used in the following ways: 1. An inflatable cuff on the outer tube seals the bronchoscope like a breathing tube against the trachea. 2. This bronchoscope, although in the endobronchial position, improves the ventilation of the contraleateral lung aided by wider side holes lying above the bifurcation. 3. Jet-ventilation can be employed.

Acidosis, Respiratory↗
PubMed1978

[An improved bronchoscope (author's transl)].

This bronchoscope differs from those normally used in the following ways: 1. In the endobronchial position the bronchoscope makes possible improvement in ventilation of the contralateral lung by increasing the area of the side-openings above the bifurcation. - 2. An inflatable cuff on the outer tube seals the bronchoscope against the trachea like a breathing tube. - 3. Jet-ventilation van be employed when the bronchoscope is open.

Bronchoscopes↗
PubMed1990

Bronchoscopic cryotherapy for advanced bronchial carcinoma.

A prospective study was carried out to assess the value of bronchoscopic cryotherapy for palliation of inoperable bronchial carcinoma with bronchial obstruction. Symptoms, lung function, and chest radiographic and bronchoscopic findings were recorded serially before and after 81 cryotherapy sessions in 33 consecutive patients. Most patients improved in terms of overall symptoms, stridor, and haemoptysis and they had an overall improvement in dyspnoea. Objective improvement in lung function was seen in 58% of patients and the changes in lung function correlated with symptoms. Bronchoscopic evidence of relief of bronchial obstruction was seen in 77% of patients and 24% showed improvement in degree of collapse on the radiograph. There were no important complications. These results compare favourably with the results in published series of patients having laser therapy. It is concluded that bronchoscopic cryotherapy is valuable for the palliation of inoperable bronchial carcinoma.

Aged↗
PubMed1991

Evaluation of a guarded bronchoscopic method for microbial sampling of the lower airways in foals.

A novel method to reduce contamination of the bronchoscope during microbial sampling of the lower airways of foals was evaluated. Methylene blue (MB) was used as a nasopharyngeal dye marker to assess the relative contamination from the upper airways of bronchoalveolar lavage (BAL) specimens obtained by standard bronchoscopy (SB) and a "guarded" bronchoscopic method (GB). For GB, a clear sterile cellulose sheath was fitted over the bronchoscope in an effort to protect the endoscope tip and channel from contamination. Methylene blue was detected visually in seven of eight BAL samples from foals following SB, but in none of the samples recovered by GB (p less than 0.001). Significantly less MB was detected in BAL by spectrophotometry in the GB group as well (p less than 0.02). The GB was next employed to study the microbial flora in the lower airways of healthy weaned foals (n = 30). Bacteria were isolated from 29 of 30 (97%) BAL samples, and in moderate or large numbers from 26 of 30 (87%) of the foals. Potential pathogens, including Bordetella bronchiseptica, Streptococcus zooepidemicus, Staphylococcus aureus, Mycoplasma felis and Streptococcus pneumoniae, were cultured from the lower airways of foals. In conclusion, the bronchoscope and bronchoalveolar lavage specimens were readily contaminated by a dye marker placed in the nasopharynx of foals, and the degree of contamination was significantly reduced by sheathing the endoscope. This contamination during bronchoscopy may obscure the interpretation of isolates from BAL specimens from foals, which may possess a bacterial flora in the lower airways without cytological evidence of inflammation.

Animals↗
PubMed1992

A study of glutaraldehyde disinfection of fibreoptic bronchoscopes experimentally contaminated with Mycobacterium tuberculosis.

Mycobacteria are difficult to inactivate, and concern about the spread of tuberculosis at bronchoscopy has a major influence on infection control practices. Recommendations from the UK Department of Health are based largely on in-vitro mycobactericidal assays which do not take into account the particular conditions encountered in endoscopy units. In this applied study cleaning and disinfection methods were examined using five bronchoscopes that were heavily contaminated with a recent isolate of Mycobacterium tuberculosis in sputum. Cleaning reduced contamination by a mean 3.5 log(10) colony forming units (cfu) per ml; all bronchoscopes were free of detectable mycobacteria after 10 min in 2% alkaline glutaraldehyde (AG). It is recommended that all bronchoscopes be thoroughly pre-cleaned and disinfected in 2% AG for 20 min as part of a uniform policy of infection control.

Bronchoscopes↗
PubMed1977

Foreign body removal with the flexible fiberoptic bronchoscope.

Intrabronchial foreign bodies are occasionally encountered in adults but most available information in humans consists only of reports evaluating one or two cases. We surveyed our experience and found seven patients with intrabronchial foreign bodies who had been examined with the flexible fiberoptic bronchoscope, six of whom were managed successfully. Nine cases have been identified in the literature. Although there were no major complications in either our cases or those in the literature, several problems were identified which under other circumstances could have caused significant complications. We assessed all of these cases for situations which presented potential risk to the patient. These risks were grouped into the following problem categories: 1. selection of appropriate bronchoscope, 2. availability of appropriate instruments, 3. control of the foreign body, and 4. unexpected foreign bodies. Endoscopists planning to use the FFB in foreign body removal should be aware of the problems and hazards which may ensue if improperly managed, and should attempt to gain experience either in the animal laboratory or in models prior to approaching patients with foreign bodies with the flexible fiberoptic bronchoscope.

Adolescent↗
PubMed1976

Flexible-bronchoscope biopsy of lung and bronchial wall in intrathoracic sarcoidosis.

1) Twenty of 25 patients (80%) with sarcoidosis had positive lung biopsies obtained by flexible-bronchoscope biopsy. 2) Three of the 5 negative biopsies were in patients with chronic sarcoidosis whose chest radiograph was unchanged for 1 yr or more. 3) Two insignificant pneumothoraces occurred as a complication of the bronchoscopic biopsy procedures. 4) Noncaseating epithelioid-cell granulomas found on fiberoptic bronchoscopic biopsy are no more specific for the diagnosis of sarcoidosis than similar findings in any other organ biopsy.

Biopsy↗
PubMed1992

Endobronchial tuberculosis. Clinical and bronchoscopic features in 121 cases.

The clinical and bronchoscopic features of endobronchial tuberculosis in 121 patients were retrospectively investigated. The peak incidence occurred in the second decades, with 3.8 times higher incidence noted in female than in male subjects. A barking cough with sputum was the most common chief complaint in 61.1 percent. Parenchymal infiltration and/or consolidation was the most common roentgenographic finding of the chest in 58.6 percent. Hypertrophy with luminal narrowing was the most common bronchoscopic finding in 43 percent. Bronchoscopically, right upper and right main bronchus were the most frequently involved in 30.5 percent. It was concluded from these data that using fiberoptic bronchoscopy allows not only substantial meaningful assessment of endobronchial tuberculosis but also relieves atelectasis eventually resulting in successful treatment with antituberculosis drugs.

Bronchi↗
PubMed1976

Tracheal stenosis. A method of dilation with use of the fiberoptic bronchoscope.

Tracheal stenosis is not an uncommon sequel of prolonged endotracheal intubation. In some cases, immediate reconstruction is not feasible. We use the flexible fiberoptic bronchoscope and a lucent, tapered endotracheal tube for tracheal dilation. The fiberoptic bronchoscope is passed through a special T connector into the endotracheal tube and used to guide the tube under direct vision through the stricture.

Adult↗
PubMed1977

Pleuroscopy and cautery control of intrathoracic hemorrhage with a flexible fiberoptic bronchoscope.

Intrathoracic hemorrhage from adhesions torn by a spontaneous pneumothorax is relatively uncommon. Continued hemorrhage from such adhesions after the evacuation of 1,500 ml of blood would usually require thoracotomy for control. Through a flexible fiberoptic bronchoscope, we confirmed the source of hemorrhage and cauterized the bleeding point. This case illustrates another application for pleuroscopic examination, further broadening the use of the flexible fiberoptic bronchoscope.

Adult↗