BACKGROUND: A forceps-biopsy is performed to acquire tissue from patients with an endobronchial carcinoma using a flexible bronchoscope. Recently, a cryo-biopsy has also been used to acquire tissue samples. Cryo-biopsy is the diagnostic application of extreme cold for the local destruction of abnormal living tissue. This technique is safe, with no radiation danger, no risk of electrical accidents, and a little risk of bleeding. This study compared a forceps-biopsy with a cryo-biopsy using a flexible bronchoscope, and examined the chemosensitivity and level of VEGF (vascular endothelial growth factor) in the specimens obtained from the cryo-biopsy. METHODS: We present a prospective study of 30 consecutive patients who underwent a forceps-biopsy between January 2007 and October 2007 with a mean age of 62.1 years and a male:female ratio of 5 : 1. A flexible bronchoscope was inserted to the area of the abnormal lesions, and a cryo-probe was then applied through the working channel of the flexible bronchoscope. A temperature of approximately -80 was delivered to the tumor site for 8 seconds. The cryo-biopsy was performed after destroying the tumor mass. RESULTS: The mean size of the tissue from the forceps-biopsy and cryo-biopsy were 2.0+/-1.2 mm and 6.0+/-3.0 mm. A chemosensitivity test was performed on 5 specimens obtained using cryo-biopsy and the level of VEGF was examined in 2 specimens obtained from a cryo-biopsy. There were no side effects in either group. CONCLUSION: Cryo-biopsy using a flexible bronchoscope is a safe and effective technique for acquiring tissue samples.
Bronchoscopes ; Bronchoscopy ; Extreme Cold ; Hemorrhage ; Humans ; Prospective Studies ; Vascular Endothelial Growth Factor A

OBJECTIVETo evaluate the impacts of air temperature on years of life lost (YLL) among the residents in Guangzhou and Zhuhai, Guangdong province.

METHODSDaily mortality and meteorology data in Guangzhou and Zhuhai were collected, and distributed lag non-linear model (DLNM) was used to evaluate the cumulative and delayed effects of daily air temperature on YLL of total non-accident mortality. The accumulative effect of air temperature on mortality under the extreme high temperature (0-1 days) and extreme low temperature (0-13 days) situation in Guangzhou and Zhuhai were analyzed respectively.

RESULTSThe average YLL was 1 928.0 in Guangzhou and 202.5 in Zhuhai. The exposure-response functions seemed to be non-linear. The hot effect seemed to be acute and reached the peak at the same day, while the cold effect reached the peak at 5(th) days and lasted for about two weeks. Low temperature had stronger gross effect than high temperature had. The cold effect among males was greater than that among females in Guangzhou. The hot/cold effect on YLL was greater in people aged ≥ 65 years than in people aged < 65 years and in people suffering from respiratory disease than in people suffering from cardiovascular disease in both Guangzhou and Zhuhai.

CONCLUSIONThe effects of high and low temperatures on YLL were obvious, and the impact of low temperature was greater. The elderly and people suffering from respiratory disease or cardiovascular disease are the vulnerable populations.

Aged ; Air ; Cardiovascular Diseases ; epidemiology ; China ; epidemiology ; Extreme Cold ; adverse effects ; Extreme Heat ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Mortality, Premature ; Nonlinear Dynamics ; Respiratory Tract Diseases ; epidemiology ; Time Factors

BACKGROUND: The efficacy of the use of the interventional bronchoscope for palliation of patients with central airway obstruction has been established. In the palliative setting to alleviate central airway obstruction, the use of laser resection, electrocautery, argon plasma coagulation, photodynamic therapy and cryotherapy can provide relief of an airway obstruction. Cryotherapy is the therapeutic application of extreme cold for the local destruction of living tissue. Recently, this technique has been used for endoscopic management of central airway obstructions in Korea. We report the role and complications of the use of cryotherapy for airway obstructions in patients with advanced lung cancer. METHODS: We used a flexible cryoprobe for cryotherapy using nitrous oxide as a cryogen. The cryoprobe was applied through the working channel of a flexible fiberoptic bronchoscope. The temperature of the tip was approximately -89degrees C, and the icing time was 5~20 seconds. RESULTS: Four patients with a central airway obstruction from advanced lung cancer were treated with cryotherapy. Three of the four patients were treated successfully and the airway obstruction was improved after the cryotherapy procedure. Dyspnea, hypoxia and atelectais were improved in three cases. Two patients experienced complications-one patient experienced pneumomediastinum and the other patient experienced massive hemoptysis during the cryotherapy procedure. However, these complications resolved and did not influence mortality. CONCLUSION: This technique is effective and relatively safe for palliation of inoperable advanced lung cancer with a central airway obstruction.
Airway Obstruction ; Anoxia ; Argon Plasma Coagulation ; Bronchoscopes ; Cryotherapy ; Dyspnea ; Electrocoagulation ; Extreme Cold ; Hemoptysis ; Humans ; Korea ; Lung ; Lung Neoplasms ; Mediastinal Emphysema ; Nitrous Oxide ; Photochemotherapy