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World Journal of Pediatric Surgery 2022年第2期5卷 29-33页

作者： Mohammad Ashkan Moslehi Pediatric interventional pulmonology division Medical SchoolShiraz University of Medical SciencesShirazIran

Background Several children are affected by airway foreign body aspiration(FBA)resulting from life-threatening conditions.Choking has been considered the major symptom and is defined as airway blockage by a foreign body(FB),leading to marked morbidity or mortality.This retrospective study indicates the possibility of misdiagnosis or rigid bronchoscope(RB)failure,which is the standard gold method for extracting FB in the airway.Methods Six children with airway FBA who failed treatment using RB between 2018 and 2019 were retrospectively studied.The inclusion criterion was a history of failure to extract FB using RB followed by flexible fiberoptic bronchoscopy(FFB).Results In the present study,among 63 patients who had undergone rigid bronchoscopy,airway FBs were successfully removed in 57(90.48%).Rigid bronchoscopy failed in 6(9.52%)patients.The age of cases at the time of bronchoscopy ranged from 11 months to 13 years.FFB was performed to extract missing or remaining FBs and was done successfully in all patients.The patients made an uneventful recovery following FB extraction using the FFB method.Conclusions It is not easy to diagnose and treat airway FB in children.Rigid bronchoscopy has been approved as a method to manage airway FB,but a negative bronchoscopy result must usually be interpreted carefully.FFB is applicable as a proper and relatively safe diagnostic and therapeutic tool in managing airway FBs among the pediatric population,especially in cases where rigid bronchoscopy was performed but missed or failed to extract the FB.

关键词： airway rigid removed

Bronchial thermoplasty

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Chinese Medical Journal 2013年第17期126卷 3375-3378页

作者： Javier Diaz-Mendoza ] BAI Chong HUANG Hai-dong Michael J. Simoff interventional pulmonology Division of Pulmonary and Critical Care Medicine Henry Ford Health System Detroit Michigan United States of America Department of Respiratory Diseases Changhai Hospital Second Military Medical University Shanghai 200433 China

Asthma is a chronic inflammatory disease that affects 300 million people worldwide. Its prevalence rangesfrom 1% to 18% of the population in different countries. The World Health Organization has estimated that 15 million disability-adjusted life years are lost annually due to asthma. Worldwide deaths from asthma are estimated at 250 000 per year. Furthermore, asthma is a major cause of absence from work in many countries, including United States .

关键词： asthma bronchial thermoplasty airway smooth muscle

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快速现场评估在经支气管针吸活检中的应用进展及存在的问题

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中华结核和呼吸杂志 2015年第7期38卷 549-551页

作者：刘庆华 Ko-Pen Wang 山东大学附属省立医院呼吸科济南250041 interventional pulmonology division of Pulmonary Medicine and Critical Care Johns Hopkins University School of Medicine U S A

对脏器或病变针吸组织行快速现场评估（rapid on-site evaluation,ROSE）,已有多年临床应用历史,尤其近些年在TBNA中应用也日益广泛,然而学者们关于ROSE在TBNA中应用价值等方面认识尚不一致.有研究认为ROSE提高了TBNA的诊断率,具有减少T... 详细信息

对脏器或病变针吸组织行快速现场评估（rapid on-site evaluation,ROSE）,已有多年临床应用历史,尤其近些年在TBNA中应用也日益广泛,然而学者们关于ROSE在TBNA中应用价值等方面认识尚不一致.有研究认为ROSE提高了TBNA的诊断率,具有减少TBNA穿刺数、简便可行的优点[1-2],但也有人提出相反的意见[3-4].本文就ROSE在TBNA中的应用进展和存在的一些问题做简要阐述.

关键词：经支气管针吸活检临床应用评估 TBNA 诊断率

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Epidemiological Evolution of Lung Cancer in the South of Spain from 1990 to 2010

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中国肺癌杂志 2018年第1期21卷 32-36页

作者： Alberto Caballero Vázquez Ana Dolores Romero Ortiz Jose Manuel González de Vega San Román Raimundo García del Moral Bernardino Alcázar Navarrete interventional pulmonology Unit Universitary Hospital Virgen de las NievesGranada Spain

Background: Changes in lung cancer has been characterized by the increase of cases among women and the increase in adenocarcinomas among other histological subtypes.Methods: Descriptive analysis of cases diagnosed with lung cancer in Hospital Virgen de las Nieves(Spain) from 1990 to 2010,based on five variables(age, sex, smoking, histology and pathological anatomy). The study establishes associations between these variables and compares the results with the literature.Results: 2,026 patients were diagnosed with lung cancer in this period; 1,838 were males(90.7%) and 188 women(9.3%); 1,892 patients(93.4%) were smokers or ex-smokers and 134(6.6%) had never smoked; the most frequent non-small cell histology types were squamous cell carcinoma and adenocarcinoma and it was the most frequent neoplasia in women and were associated with a lower tobacco consumption.Conclusion: The large majority of lung cancer cases is associated with a history of smoking tobacco and there are histopathological differences according to gender and cumulative tobacco smoke load.

关键词： Evolution

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Endoscopic identification of endoluminal esophageal landmarks for radial and longitudinal orientation and lesion location

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World Journal of Gastroenterology 2019年第4期25卷 498-508页

作者： Fabian Emura Rene Gomez-Esquivel Carlos Rodriguez-Reyes Petros Benias Javier Preciado Michael Wallace Luis Giraldo-Cadavid division of Gastroenterology Universidad de La Sabana Advanced Gastrointestinal Endoscopy EmuraCenter LatinoAmerica Emura Foundation for the Promotion of Cancer Research Unidad de Endoscopia Digestiva Clínica Pediátrica Colsanitas division of Digestive Diseases and Nutrition Morsani College of Medicine University of South Florida division of Gastroenterology North Shore-Long Island Jewish Medical Center Unidad de Exploraciones Digestivas Clinica Universitaria Colombia Department of Gastroenterology and Hepatology Mayo Clinic Department of Internal Medicine. Universidad de La Sabana Division of Interventional Pulmonology Fundacion Neumologica Colombiana

AIM To characterize esophageal endoluminal landmarks to permit radial and longitudinal esophageal orientation and accurate lesion location.METHODS Distance from the incisors and radial orientation were estimated for the main left bronchus and the left atrium landmarks in 207 consecutive patients using white light examination. A sub-study was also performed using white light followed by endoscopic ultrasound(EUS) in 25 consecutive patients to confirm the findings.The scope orientation throughout the exam was maintained at the natural axis,where the left esophageal quadrant corresponds to the area between 6 and 9 o'clock. When an anatomical landmark was identified, it was recorded with a photograph and its quadrant orientation and distance from the incisors were determined. The reference points to obtain the distances and radial orientation were as follows: the midpoint of the left main bronchus and the most intense pulsatile zone of the left atrium. With the video processor system set to moderate insufflation, measurements were obtained at the end of the patients' air expiration.RESULTS The left main bronchus and left atrium esophageal landmarks were identified using white light in 99% and 100% of subjects at a mean distance of 25.8 cm(SD2.3), and 31.4 cm(SD 2.4) from the incisors, respectively. The left main bronchus landmark was found to be a tubular, concave, non-pulsatile, esophageal external compression, occupying approximately 1/4 of the circumference. The left atrium landmark was identified as a round, convex, pulsatile, esophageal external compression, occupying approximately 1/4 of the circumference. Both landmarks were identified using white light on the anterior esophageal quadrant. In the substudy, the left main bronchus was identified in 24(92%) patients at 25.4 cm(SD2.1) and 26.7 cm(SD 1.9) from the incisors, by white light and EUS, respectively.The left atrium was recognized in all patients at 30.5 cm(SD 1.9), and 31.6 cm(SD2.3) from the incisors, by both white light and EUS, respectively. EUS confi

关键词： Esophagus Natural landmark Radial orientation Longitudinal orientation Four-quadrants Left main bronchus Left atrium

Passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts and assessment of clinical outcomes

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World Journal of Hepatology 2017年第12期9卷 603-612页

作者： Michael C Hsu Charles N Weber S William Stavropoulos Timothy W Clark Scott O Trerotola Richard D Shlansky Goldberg Michael C Soulen Gregory J Nadolski Department of Radiology Division of Interventional RadiologyMount Sinai Hospital Department of Radiology Division of Interventional RadiologyHospital of the University of Pennsylvania

AIM To assess for passive expansion of sub-maximally dilated transjugular intrahepatic portosystemic shunts(TIPS) and compare outcomes with maximally dilated TIPS.METHODS Polytetrafluoroethylene covered TIPS(Viatorr) from July 2002 to December 2013 were retrospectively reviewed at two hospitals in a single institution. Two hundred and thirty patients had TIPS maximally dilated to 10 mm(m TIPS), while 43 patients who were at increased risk for hepatic encephalopathy(HE), based on clinical evaluation or low pre-TIPS portosystemic gradient(PSG), had 10 mm TIPS sub-maximally dilated to 8 mm(sm TIPS). Group characteristics(age, gender, Model for End-Stage Liver Disease score, post-TIPS PSG and clinical outcomes were compared between groups, including clinical success(ascites or varices), primary patency,primary assisted patency, and severe post-TIPS HE. A subset of fourteen patients with sm TIPS underwent follow-up computed tomography imaging after TIPS creation, and were grouped based on time of imaging( 6 mo). Change in diameter and crosssectional area were measured with 3D imaging software to evaluate for passive expansion.RESULTS Patient characteristics were similar between the sm TIPS and m TIPS groups, except for pre-TIPS portosystemic gradient, which was lower in the sm TIPS group(19.4 mm Hg ± 6.8 vs 22.4 mm Hg ± 7.1, P = 0.01). Primary patency and primary assisted patency between sm TIPS and m TIPS was not significantly different(P = 0.64 and 0.55, respectively). Four of the 55 patients(7%) with sm TIPS required TIPS reduction for severe refractory HE, while this occurred in 6 of the 218 patients(3%) with m TIPS(P = 0.12). For the 14 patients with follow-up computed tomography(CT) imaging, the median imaging follow-up was 373 d. There was an increase in median TIPS diameter, median percent diameter change, median area, and median percent area change in patients with CT follow-up greater than 6 mo after TIPS placement compared to follow-up within 6 mo(8.45 mm, 5.58%, 56.04 mm^2, and 11.48%, respecti

关键词： Variceal 出血门高血压 Transjugular intrahepatic portosystemic 分流腹水亚 maximal 膨胀 Underdilated 被动扩大肝的 encephalopathy

Third-space endoscopy:the final frontier

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Gastroenterology Report 2023年第1期11卷 14-23页

作者： Maham Hayat Dennis Yang Peter V.Draganov Center for interventional Endoscopy AdventHealthOrlandoFLUSA division of Gastroenterology Hepatologyand NutritionUniversity of FloridaGainesvilleFLUSA

Over the years,our growing experience with endoscopic submucosal dissection along with technological advances has so-lidiﬁed our comfort and knowledge on working in the submucosa,also referred to as the“third space.”Per-oral endoscopic myotomy(POEM)was theﬁrst prototype third-space endoscopy(TSE)procedure,demonstrating the feasibility and clinical utility of endoscopic esophagogastric myotomy via submucosal tunneling.The launch of POEM accelerated the evolution of TSE from a vanguard concept to an expandingﬁeld with a wide range of clinical applications.In this review,we discuss the status and future directions of multiple TSE interventions.

关键词： endoscopy final frontier therapeutic endoscopy third-space endoscopy submucosal endoscopy

Treatment modalities for hypersplenism in liver transplant recipients with recurrent hepatitis C

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World Journal of Gastroenterology 2009年第40期15卷 5010-5013页

作者： Lena Sibulesky Justin H Nguyen Ricardo Paz-Fumagalli C Burcin Taner Rolland C Dickson division of Transplant Surgery and Transplant Hepatology Division of Interventional Radiology

Hepatitis C is the most common indication for orthotopic liver transplantation in the United States. Unfortunately, hepatitis C recurs universally in the transplanted liver and is the major cause of decreased graft and patient survival. The combination therapy of interferon and ribavirin has been shown to be the most effective therapy for recurrent hepatitis C. However, pre-and post-transplant hypersplenism often precludes patients from receiving the antiviral therapy. Splenectomy and partial splenic embolization are the two invasive modalities that can correct the cytopenia associated with hypersplenism. In this report we review the two treatment options, their associated outcomes and complications.

关键词：丙型肝炎联合治疗脾动脉肝移植复发抗病毒药物利巴韦林治疗方案

内镜下氰基丙烯酸酯注射联合胃肾分流球囊闭塞下逆行经静脉栓塞术(BRTOcc)治疗胃底静脉曲张出血的有效性和安全性

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Gastroenterology Report 2021年第3期9卷 212-218,I0001,I0002页

作者： Fateh Bazerbachi Akira Dobashi Swarup Kumar Sanjay Misra Navtej S.Buttar Louis M.Wong Kee Song division of Gastroenterology Interventional Endoscopy ProgramMassachusetts General Hospital and Harvard Medical SchoolBostonMAUSA division of Gastroenterology and Hepatology Mayo ClinicRochesterMNUSA Vascular and interventional Radiology Mayo ClinicRochesterMNUSA

背景:内镜下氰基丙烯酸酯注射治疗胃底静脉曲张,可能会通过自发性胃肾分流导致严重的栓塞性事件。在内镜下氰基丙烯酸酯注射时,对胃肾分流进行球囊闭塞下逆行经静脉栓塞术(BRTOcc)或可预防因胃肾分流造成的严重系统性栓塞。本研究旨在... 详细信息

背景:内镜下氰基丙烯酸酯注射治疗胃底静脉曲张,可能会通过自发性胃肾分流导致严重的栓塞性事件。在内镜下氰基丙烯酸酯注射时,对胃肾分流进行球囊闭塞下逆行经静脉栓塞术(BRTOcc)或可预防因胃肾分流造成的严重系统性栓塞。本研究旨在评估联合BRTOcc治疗胃底静脉曲张出血的疗效和安全性。方法:回顾性分析在2010年1月至2018年4月间接受联合BRTOcc治疗的急性胃底静脉曲张出血患者的资料,包括患者人口统计资料、临床/内镜特征、治疗情况、治疗相关的不良事件及临床结局。结果:30例患者纳入研究,其中女性13例(43.3%),中位年龄58(范围:25-29)岁。按Sarin分类,食管胃底静脉曲张(2型)16例(53.3%),单纯胃底静脉曲张(1型)14例(46.7%)。中位临床随访时间151(范围:4-2,513)天,中位内镜随访时间98(范围:3-2,373)天。中位氰基丙烯酸酯/碘油注射量7(范围:4-22)mL。3例(10.0%)患者出现手术相关的不良事件,包括短暂发热、轻度肺栓塞和注射部位溃疡出血。内镜随访发现,21例患者中18例(85.7%)胃底静脉曲张完全闭塞;1例(3.3%)患者发生延迟的静脉曲张再出血,另2例(6.7%)疑似发生再出血。尽管未出现手术相关的死亡,但总体病死率高达46.7%,主要是死于肝病进展及合并症。结论:对于胃底静脉曲张出血, 内镜下注射联合BRTOcc是一种相对安全有效的治疗方法, 可获得比较高的静脉曲张闭塞率, 同时严重不良事件发生率较低。

关键词：胃底静脉曲张静脉栓塞术氰基丙烯酸酯内镜下临床结局人口统计资料再出血溃疡出血

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穿刺损伤在介入放射学中常见但鲜有上报

国际医学放射学杂志 2018年第1期 102-103页

作者： A.R.Deipolyi A.M.Prabhakar S.Naidu R.Oklu 周波 division of interventional Radiology Mayo Clinic

摘要目的明确穿刺损伤在介入放射科医师中的发生率和危险因素,支持或反对上报穿刺损伤的态度、行为和情形。材料与方法通过邮件发送给所有介入放射学学会会员,

关键词：穿刺损伤介入放射学放射科医师