BackgroundRecent advances in bronchoscopy, such as transbronchial biopsy (TBB) using endobronchial ultrasonography with a guide sheath (EBUS-GS), have improved the diagnostic yield of small-sized peripheral lung lesions. In some cases, however, it is difficult to obtain adequate biopsy samples for pathological diagnosis. Adequate prediction of the diagnostic accuracy of TBB with EBUS-GS is important before deciding whether bronchoscopy should be performed.MethodsWe retrospectively reviewed 149 consecutive patients who underwent TBB with EBUS-GS for small-sized peripheral lung lesions (≤30 mm in diameter) from April 2012 to March 2013. We conducted an exploratory analysis to identify clinical factors that can predict an accurate diagnosis by TBB with EBUS-GS. All patients underwent thin-section chest computed tomography (CT) scans (0.5-mm slices), and the CT bronchus sign was evaluated before bronchoscopy in a group discussion. The final diagnoses were pathologically or clinically confirmed in all studied patients (malignant lesions, 110 patients; benign lesions, 39 patients).ResultsThe total diagnostic yield in this study was 72.5 % (95 % confidence interval: 64.8–79.0 %). Lesion size, lesion visibility on chest X-ray, and classification of the CT bronchus sign were factors significantly associated with the definitive biopsy result in the univariate analysis. In the multivariate analysis, only the CT bronchus sign remained as a significant predictive factor for successful bronchoscopic diagnosis. The CT bronchus sign was also significantly associated with the EBUS findings of the lesions.ConclusionOur results suggest that the CT bronchus sign is a powerful predictive factor for successful TBB with EBUS-GS.

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⛤ǽᡡ℗ȡሱǨȚ Zr 1ࢬx Hf x V 2 O 7 ࡘΧǽᭀåᲡ ˳ʄ‫ރ‬Ȗɿ୮‫ރۑ‬౪ɿŊ ᲂɿ୮ቧᗬ˳ଉ ‫ل‬іӞᴻᲇકཪ⒈গકрগકɦɎɲȪɳȽȬȰɻɁᮾ᳣ᲇࢫ923-1292 ᮸᭔ῡలᅨ۞ 1-1 ଉ ᵹᗢগકগકрᄋᥴᢼᲇકᮾ᳣ᲇ‫ك‬કଗფࢫ305-8571 ⇹᭔dzǞǿలঙ۞ 1-1-1The phase transition of Zr 1ࢬx Hf x V 2 O 7 xࢼ0-1 solid solutions substituted for ZrIV sites was investigated using X-ray diffraction, TMA and DSC methods. X-ray diffraction experiments revealed that all compositions of Zr 1ࢬx Hf x V 2 O 7 xࢼ0-1 were of a single phase having a cubic structure. Lattice parameters of Zr 1ࢬx Hf x V 2 O 7 xࢼ0-1 at room temperature decreased linearly with increasing Hf content, due to the smaller ionic radius of the HfIV ion than that of the ZrIV ion. Abrupt positive thermal expansions in TMA were observed for all samples at two phase transition temperatures in the vicinity of T 1 ࢼ350 K and T 2 ࢼ375 K, and negative thermal expansions were seen above about 380 K. DSC measurements clearly showed that all of the Zr 1ࢬx Hf x V 2 O 7 xࢼ 0-1 samples also underwent two successive phase transitions between 330 and 390 K. Two transition temperatures and phase transition enthalpies of Zr 1ࢬx Hf x V 2 O 7 xࢼ0-1 samples decreased with the increase of x content, reflecting the decrease of superlattice structure. The sum of transition entropy for successive two phase transitions increased with increasing the normalized relative intensity of the superlattice line at room temperature.

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Background:Bronchial occlusion with an Endobronchial Watanabe Spigot (EWS) has been shown to be useful in managing prolonged bronchopleural fistulas and intractable hemoptysis. EWS bronchial occlusion using a curette is less technically demanding. This retrospective study evaluated the clinical utility and simplicity of this method.Methods:A total of 18 consecutive patients (15 men, 3 women, aged 47–85 years) who underwent bronchial occlusion using an EWS from April 2012 to August 2014 were evaluated. The method involves sticking the tip of a curette into an EWS to the first joint, allowing it to be turned in any direction or at any angle. The time required to occlude the target bronchus was measured on routinely recorded digital videos. Other parameters evaluated included success rates, complications, and clinical outcomes.Results:Of the 18 patients, 11 underwent bronchial occlusion for intractable pneumothorax, 5 for postoperative bronchopleural fistula, two for intractable empyema, and one for hemoptysis. Each patient required 1–7 EWSs (median 4). Target bronchi included the right upper (n = 8), left upper (n = 5), right lower (n = 2), left lower (n = 2), and right middle (n = 1) bronchi. The success rate of EWS insertion into the target bronchus was 100%. Time per EWS occlusion ranged from 65–528 sec (median 158.5 sec). Of the 62 insertions, 36 (58.1%) were completed within 3 min, and 58 (93.5%) within 5 min. Successful outcomes were observed in 15 (83.3%) of the 18 patients.Conclusions:EWS bronchial occlusion using a curette is a simple method for managing intractable bronchopleural fistulas in daily clinical settings.