Background Bronchial Dieulafoy’s disease (BDD) is a rare disease that is known to be a cause of hemorrhage. The characteristics of this disease are still unknown. The present study describes the disorder based on a review of the world’s literature, emphasizing the diagnostic and therapeutic views. Methods A comprehensive research of BDD of the PubMed, Google Scholar, and Web of Science databases was performed. The following data were collected: patient characteristics; chest imaging, bronchoscopy, vascular angiography, and histopathologic examination findings; and treatment rendered. Results 73 cases of BDD have been reported from 1995 to 2019. Most of the cases occurred in Asia (52.1%), followed by Europe (31.5%). Chest imaging findings were non-specific. The main bronchoscopy finding was a nodular or protruding lesion (60.9%). 19 patients underwent bronchoscopic biopsies, 17 had bleeding, and 6 died. Four patients were successfully shown to have vascular malformations under mucosal protrusion by endobronchial ultrasound scan (EBUS). Vascular angiography mainly showed tortuous, dilated bronchial arteries. Vascular angiography mainly showed tortuous, dilated bronchial arteries. The arterial supply was mainly provided by bronchial arteries (48 cases) and the pulmonary circulation (4 cases). The lesions were mainly located in the right bronchus (53 cases). Selective bronchial artery embolization (BAE) was attempted in 38 patients and 20 patients underwent lobectomies. Emergency resection was performed in 15 patients, all of whom survived and had no recurrent hemoptysis. Conclusions Massive hemoptysis was the common manifestation of BDD. Vascular angiography and EBUS is a very useful examination before biopsy. BAE may be used in stable patients, or patients who cannot tolerate surgery, while surgical resection should be considered in patients who are unstable, patients with uncontrolled hemoptysis, or following BAE failure. Electronic supplementary material The online version of this article (10.1186/s12890-019-0863-1) contains supplementary material, which is available to authorized users.
Introduction To investigate the relationship of superoxide dismutase (SOD) and malondialdehyde (MDA) levels with left ventricular geometry (LVG) and function in patients with primary hypertension (PH). Methods A total of 222 PH patients and 25 healthy control (HC)s were enrolled in this study. All subjects underwent echocardiography and blood biochemical examination. PH patients were divided into four groups based on Ganau classification: normal geometry (NG) group, concentric remodeling (CR) group, eccentric hypertrophy (EH) group, and concentric hypertrophy (CH) group. Pearson correlation analysis and logistic regression analysis were used to analyze the relationship between SOD and MDA with left ventricular structure and function. Results Compared to the HC, NG and CR groups, MDA level was higher while SOD level was lower in the EH and CH groups (all P < 0.001). SOD level was negatively correlated with IVSd, LVDd, LVPW, and global longitudinal strain (GLS), but positively correlated with LVEF. MDA level was positively correlated with IVSd, LVPW, and GLS, while negatively correlated with e'/a' and LVEF. SOD and MDA were independently associated with CR (OR = 0.970, P = 0.003; OR = 1.204, P = 0.043), EH (OR = 0.879, P < 0.001; OR = 2.197, P = 0.001) and CH (OR = 0.796, P < 0.001; OR = 3.669, P < 0.001). Conclusion The SOD and MDA levels were correlated with LVG and function in PH patients. SOD and MDA may be important influencing factors of LVG change.
Objective: To assess the relationship of interleukin-6 (IL-6) and C-reactive protein (CRP) levels with left ventricular geometry (LVG) and function in patients with obstructive sleep apnea syndrome (OSAS) and pre-hypertension.Methods: A total of 458 patients were assigned into four groups: normal geometry (NG), concentric remodeling (CR), eccentric hypertrophy (EH), and concentric hypertrophy (CH). Pearson correlation and multivariate logistic regression analyses were used to determine the correlation between IL-6, CRP, and clinical, polysomnographic, and biochemical parameters with LVG and function.Results: IL-6 and CRP levels were higher in the EH and CH groups than those in the NG and CR groups. The results of the Pearson correlation analysis showed that IL-6 level was positively correlated with the E/e' ratio and peak systolic pulmonary venous reverse velocity (PVa) duration time (PVaD), while negatively correlated with the E/A ratio, s' , and left ventricular ejection fraction (LVEF). CRP level was positively correlated with A-wave duration time (AD), peak systolic pulmonary venous flow velocity (PVs), PVa and PVaD, while negatively correlated with the E/A ratio. The results of the multivariate logistic regression analysis revealed that IL-6 and CRP levels were corre-
Objective Rapid on-site evaluation has long been used for transbronchial needle aspiration or fine-needle aspiration to evaluate the adequacy of biopsy materials for the diagnosis of peripheral lung lesions. However, research on rapid on-site evaluation combined with transbronchial forceps biopsy in the diagnosis of lung carcinoma is rarely reported. Therefore, we aimed to investigate the value of rapid on-site evaluation during transbronchial forceps biopsy for endoscopically visible (tumor, infiltrative and necrotic) or nonvisible (compressive, nonspecific and normal) malignancy. Methods A retrospective analysis was performed between January 2015 and January 2019 in Taihe Hospital with 1216 lung cancer patients who underwent bronchoscopy procedures, and these patients were allocated into the rapid on-site evaluation group and non-rapid on-site evaluation group, depending on the timing of the procedure. According to endoscopic features, bronchoscopic appearance was described as endoscopically visible malignancy (tumor, infiltrative and necrotic) and endoscopically nonvisible malignancy (compressive, nonspecific and normal). The diagnostic yield was compared, and the concordance between the rapid on-site evaluation results and the final histology was analyzed. Results There was a statistically significant difference in the diagnostic yield between the rapid on-site evaluation and non-rapid on-site evaluation groups for endoscopically nonvisible malignancy (74.3% vs. 51.7%, P < 0.05). However, we found no significant improvement in terms of diagnostic yield for endoscopically visible malignancy (95.2% vs. 91.2%, P > 0.05). The rapid on-site evaluation results showed high-level concordance with histology in the diagnosis of squamous cell carcinoma, adenocarcinoma and small cell carcinoma, with kappa values of 0.749 (P < 0.05), 0.728 (P < 0.05) and 0.940 (P < 0.05), respectively. Conclusions The findings demonstrated that the diagnostic yield of transbronchial biopsy for endoscopically nonvisible malignancy (compressive, nonspecific and normal) was significantly improved when rapid on-site evaluation was implemented. In addition, the rapid on-site evaluation results had high-level concordance with the final histological diagnosis.
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