scholarly journals Sex differences in large conducting airway anatomy

2018 ◽  
Vol 125 (3) ◽  
pp. 960-965 ◽  
Author(s):  
Paolo B. Dominelli ◽  
Juan G. Ripoll ◽  
Troy J. Cross ◽  
Sarah E. Baker ◽  
Chad C. Wiggins ◽  
...  
Keyword(s):  
Sex Differences ◽  
Main Bronchus ◽  
Lower Lobe ◽  
Left Lower Lobe ◽  
Smoking History ◽  
Men And Women ◽  
Previous Evidence ◽  
Healthy Women ◽  
Luminal Area ◽  
Conducting Airways

Airway luminal area is the major determinant of resistance to airflow in the tracheobronchial tree. Women may have smaller central conducting airways than men; however, previous evidence is confounded by an indirect assessment of airway geometry and by subjects with prior smoking history. The purpose of this study was to examine the effect of sex on airway size in healthy nonsmokers. Using low-dose high-resolution computed tomography, we retrospectively assessed airway luminal area in healthy men ( n = 51) and women ( n = 73) of varying ages (19–86 yr). Subjects with a positive smoking history, cardiopulmonary disease, or a body mass index > 40 kg/m2 were excluded. Luminal areas of the trachea, right and left main bronchus, bronchus intermediate, left and right upper lobes, and the left lower lobe were analyzed at three discrete points. The luminal areas of the conducting airways were ~26%–35% smaller in women. The trachea had the largest differences in luminal area between men and women (298 ± 47 vs. 195 ± 28 mm2 or 35% smaller for men and women, respectively), whereas the left lower lobe had the smallest differences (57 ± 15 vs. 42 ± 9 mm2 or 26% smaller for men and women, respectively). When a subset of subjects was matched for height, the sex differences in airway luminal area persisted, with women being ~20%–30% smaller. With all subjects, there were modest relationships between height and airway luminal area ( r = 0.73–0.53, P < 0.05). Although there was considerable overlap between sexes, the luminal areas of the large conducting airways were smaller in healthy women than in men. NEW & NOTEWORTHY Previous evidence for sex differences in airway size has been confounded by indirect measures and/or cohorts with significant smoking histories or pathologies. We found that central airways in healthy women were significantly smaller (~26%–35%) than men. The significant sex-difference in airway size was attenuated (20%–30% smaller) but preserved in a subset of subjects matched for height. Over a range of ages, healthy women have smaller central airways than men.

scholarly journals Evidence for dysanapsis using computed tomographic imaging of the airways in older ex-smokers

2009 ◽  
Vol 107 (5) ◽  
pp. 1622-1628 ◽  
Author(s):  
A. William Sheel ◽  
Jordan A. Guenette ◽  
Ren Yuan ◽  
Lukas Holy ◽  
John R. Mayo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Tomographic Imaging ◽  
Smoking History ◽  
Men And Women ◽  
Male And Female ◽  
Computed Tomographic ◽  
Males And Females ◽  
Airway Tree ◽  
Conducting Airways ◽  
The Relationship

We sought to determine the relationship between lung size and airway size in men and women of varying stature. We also asked if men and women matched for lung size would still have differences in airway size and if so where along the pulmonary airway tree would these differences exist. We used computed tomography to measure airway luminal areas of the large and central airways. We determined airway luminal areas in men ( n = 25) and women ( n = 25) who were matched for age, body mass index, smoking history, and pulmonary function and in a separate set of men ( n = 10) and women ( n = 11) who were matched for lung size. Men had greater values for the larger airways and many of the central airways. When male and female subjects were pooled there were significant associations between lung size and airway size. Within the male and female groups the magnitudes of these associations were decreased or nonsignificant. In males and females matched for lung size women had significantly smaller airway luminal areas. The larger conducting airways in females are significantly smaller than those of males even after controlling for lung size.

scholarly journals The left main bronchus transected incorrectly during video-assisted thoracoscopic lobectomy: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuma Shindo ◽  
Masahiro Miyajima ◽  
Yasuyuki Nakamura ◽  
Wataru Arai ◽  
Ryunosuke Maki ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Main Bronchus ◽  
Lower Lobe ◽  
Left Main Bronchus ◽  
Left Lower Lobe ◽  
Left Main ◽  
Lobe Bronchus ◽  
Intraoperative Complication ◽  
Pleural Adhesion ◽  
Lower Lobectomy

Abstract Background Several severe intraoperative complications of lung cancer surgery have been reported, but the incorrect transection of the main bronchus is a very rare and serious complication. We report a surgical case of a patient with left lower lobe lung cancer invading the inferior segment of the lingula, with fused interlobar fissure and dense pleural adhesion, in which the left main bronchus was mistaken for the left lower lobe bronchus and was transected. Case presentation A 64-year-old woman with lung adenocarcinoma was referred to our hospital for surgical treatment. Chest computed tomography (CT) scan showed a 30-mm nodule with a clear border and irregular margins in the center of the anterior (S8) segment of the lower lobe of the left lung and another similar 30-mm nodule in the lateral (S9) segment of the same lobe. Metastasis within the same lobe was suspected. A thoracoscopic left lower lobectomy was scheduled for the patient. As the patient had a moderately, fused fissure, dense pleural adhesion, and suspicious tumor invasion from the left S8 segment to the left S5 segment, and the interlobar node tightly adhered to the main PA at the site of basilar artery origin of the LLL, we performed left lower lobectomy and a left S5 segmentectomy using the fissureless fissure-last technique. During surgery, the left main bronchus was mistaken for the left lower lobe bronchus and was transected. After transecting the left main bronchus, we performed a sleeve bronchoplasty to prevent pneumonectomy. Conclusions We experienced the rare and serious intraoperative complication of the incorrect transection of the main bronchus. There are few reports of this intraoperative complication, and it should not be overlooked by surgeons.

scholarly journals Foreign Body In Airways

JMS SKIMS ◽  
2014 ◽  
Vol 17 (1) ◽  
pp. 36
Author(s):  
Manzoor Latoo ◽  
Aleena Jallu ◽  
Rafiq Pampori ◽  
Mudasir Ul Islam
Keyword(s):  
Foreign Body ◽  
Chest Radiograph ◽  
Main Bronchus ◽  
Lower Lobe ◽  
Lung Parenchyma ◽  
Left Lower Lobe ◽  
Chest Examination ◽  
History Of ◽  
Time Of Presentation ◽  
Relevant Finding

A 13 year old girl presented with history of foreign body (metallic pin) inhalation/ingestion the day before, which was associated with an episode of choking and cough. Patient was asymptomatic at the time of presentation and had no relevant finding on chest examination and I/L examination. Chest radiograph revealed foreign body in the periphery outside the main bronchus and secondary bronchus giving an impression of the foreign body in left lower lobe lung parenchyma (Fig. 1) following which CT chest was ordered. JMS 2014;17(1):36

scholarly journals Rare case: paraneoplastic syndrome affecting peripheral nerves, associated with anti-collapsin-response mediator protein-5 (anti-CRMP5) antibodies, as early manifestation of small cell lung cancer confined to a solitary lymph node without evidence of lung mass on routine CT thorax

2020 ◽  
Vol 13 (2) ◽  
pp. e232656 ◽  
Author(s):  
Umar Khan ◽  
Sanval Ahmed Warriach
Keyword(s):  
Lymph Node ◽  
Main Bronchus ◽  
Small Cell Lung Carcinoma ◽  
Lower Lobe ◽  
Small Cell ◽  
Left Lower Lobe ◽  
Endobronchial Ultrasound ◽  
Small Cell Lung ◽  
Limb Weakness ◽  
Cell Lung Carcinoma

A 69-year-old woman presented with 9 months history of progressively worsening upper and lower limb weakness leading to reduced functional status. She was diagnosed with peripheral neuropathy (predominantly sensory) initially and had received immunoglobulins and pulsed steroid therapy with no benefit. She was following up with respiratory team for surveillance of hamartoma in left lower lobe. Investigations included a battery of serum samples and tissue samples on two different occasions. Anti-HU and anti-CV2 antibodies were found positive in serum. Sural nerve biopsy raised suspicion of paraneoplastic phenomenon. CT thorax abdomen and pelvis was carried out to identify a primary neoplastic source; however no lesion was identified except for the previously documented hamartoma in the left lower lobe. Positron emission tomography (PET) scan was carried out that identified a single fluorodeoxyglucose (FDG)-avid focus either in the mid oesophagus or in the left para oesophageal region below the left main bronchus. Gastroscopy showed evidence of inflammation only. Bronchoscopy/endobronchial ultrasound (EBUS)-guided lymph node biopsy turned out be small cell lung carcinoma on histological analysis. She was then referred to oncology services, and received 4 cycles of carboplatin/etoposide chemotherapy followed by 30 fractions of radiotherapy. She finished chemotherapeutic treatment without any complications. So far her symptoms have not settled, but not worsening anymore and she continues physiotherapy to regain limb function.

scholarly journals Multiple endo bronchial lipoma: a rare case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shunjin Zhao ◽  
Yuexiang Shui ◽  
Zhong Dai
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Main Bronchus ◽  
Tumor Resection ◽  
Lower Lobe ◽  
Left Main Bronchus ◽  
Left Lower Lobe ◽  
Heavy Smoker ◽  
Left Main ◽  
Segmental Bronchus

Abstract Background Endobronchial lipoma is an extremely rare benign tumor, which is generally located in the first three subdivisions of the tracheobronchial tree. According to the existing literature, all endobronchial lipomas are single (one per patient). Here, we report a rare case in which the patient presented with two endobronchial lipomas in the same patient, and underwent a bronchoscopic tumor resection in the left main bronchus and the left lower bronchus. Both tumors were pathologically confirmed as endobronchial lipoma. Case presentation A 52-year-old Chinese man presented at the clinic reporting a mild cough with yellow color sputum and exertional dyspnea for 2 weeks. He was a heavy smoker (45 pack-years). Chest auscultation demonstrated faint wheezing in left lower lobe. Computed tomography (CT) revealed two low-density endobronchial masses located in the middle segment of the left main bronchus and the posterior basilar segmental bronchus of the left lower lobe. The neoplasms measured a CT-attenuation value of -70HU, −98HU in density with air trapping and atelectasis in the segmental bronchus of the left lower lobe. The patient underwent interventional bronchoscopic management to remove the neoplasms by using an electrosurgical snare, cryotherapy, and electrocautery. The locations of the neoplasms were confirmed at the left main bronchus and the superior segment of the left lower lobe during bronchoscopic intervention. Histopathological examination confirmed that both tissues were consistent with lipomas. After 18 months of follow-up, the patient was free of symptoms and CT revealed that bronchiectasia remained in the superior segment of the left lower lobe; however, no mass lesion was present in the left bronchus. Conclusions This case suggests that an endobronchial lipoma can present as multiple lesions, and both proximal and distal types can simultaneously occur in the same patient. Thus, these findings help us further understand the biology of endobronchial lipomas.

Postpneumonectomy airway growth in the ferret

1985 ◽  
Vol 58 (3) ◽  
pp. 1010-1014 ◽  
Author(s):  
J. T. McBride
Keyword(s):  
Lung Volume ◽  
Lung Resection ◽  
Lower Lobe ◽  
Cross Sectional Area ◽  
Left Lower Lobe ◽  
Sectional Area ◽  
Cross Sectional ◽  
Peripheral Airways ◽  
Four Levels ◽  
Conducting Airways

To investigate the participation of the conducting airways in compensatory growth following partial lung resection, bronchial casts of six ferrets having undergone right-sided pneumonectomy at 8 wk of age were compared with those of five sham-operated control animals. At maturity, the left lungs of the postpneumonectomy animals were 65% larger than those of the controls. Central airway cross-sectional areas at 10 specific locations in each cast were 12% larger in the postpneumonectomy animals compared with controls. To characterize the size of more peripheral airways, the size and number of the terminal bronchioles subtended by each airway in each left lower lobe cast were identified so that the fraction of the lobe served by that airway could be estimated. The characteristic cross-sectional areas of airway serving 0.7, 2.2, and 9.5% of the left lower lobe in postpneumonectomy animals were 18, 13, and 13% larger than those of controls, but this difference was statistically significant only at the two more peripheral levels. Although airway areas were larger in postpneumonectomy animals, the ratio of airway cross-sectional area to the 0.67 power of lung volume was 20–26% smaller in operated than in control animals at each of the four levels. Following pneumonectomy in the weanling ferret, central and peripheral conducting airways increase in cross-sectional area to similar degrees, but this airway growth is less than the compensatory increase in lung volume.

Digit Ratio (2D:4D) and Behavioral Responses to Everyday Life and Workplace-Related Interpersonal Conflict

2010 ◽  
Vol 69 (1) ◽  
pp. 31-37 ◽  
Author(s):  
Martin Voracek ◽  
Kerstin Schicker
Keyword(s):  
Sex Differences ◽  
Relational Aggression ◽  
Interpersonal Conflict ◽  
Community Sample ◽  
Behavioral Responses ◽  
Digit Ratio ◽  
Men And Women ◽  
Previous Evidence ◽  
Finger Length ◽  
Fourth Digit

Relationships of second-to-fourth digit ratio (2D:4D) versus absolute finger length, two putative markers for prenatal vs. pubertal-adolescent testosterone exposure, with specific behavioral responses to interpersonal conflict, as assessed with the Conflict Dynamics Profile (CDP; Davis, Capobianco, & Kraus, 2004), were examined in an adult community sample of 132 men and women. Paralleling related findings for specific types of aggression (namely, reactive and indirect, i.e., social/relational aggression), results showed analogous sex differences for conflict-related behaviors. Specifically, women scored significantly higher than men on the CDP Hot Buttons component, assessing upset in response to workplace-related conflict elicited by problematic behavior of workmates. Among women (but not men), higher Hot Button scores corresponded significantly to higher prenatal testosterone (indexed by lower 2D:4D). Extending previous evidence for associations between 2D:4D and aggression, this suggests possible contributions of prenatal sex-hormonal masculinization to within-sex individual variation in specific types of conflict-related behavior.

Dysanapsis in men and women with obesity

2021 ◽  
Author(s):  
Jonathon Lee Stickford ◽  
Daniel P. Wilhite ◽  
Dharini M. Bhammar ◽  
Bryce N. Balmain ◽  
Tony G. Babb
Keyword(s):  
Transpulmonary Pressure ◽  
Pulmonary Mechanics ◽  
Significant Group ◽  
Men And Women ◽  
Luminal Area ◽  
Occlusion Technique ◽  
Expiratory Flow ◽  
Reported Data ◽  
Conducting Airways ◽  
Function Testing

Obesity alters chest wall mechanics, reduces lung volumes, and increases airway resistance. In addition, the luminal area of the larger conducting airways is smaller in women than in men when matched for lung size. We examined whether differences in pulmonary mechanics with obesity and sex were associated with the dysanapsis ratio (DR), an estimate of airway size when expiratory flow is maximal, in men and women with and without obesity. Additionally, we examined the ability to estimate DR using predicted versus measured static recoil pressure at 50%FVC (Pst50FVC). Participants completed pulmonary function testing and measurements of pulmonary mechanics. Flow, volume, and transpulmonary pressure were recorded while completing forced vital capacity (FVC) maneuvers in a body plethysmograph. Static compliance curves were collected using the occlusion technique. DR was calculated using measured values of forced mid-expiratory flow and Pst50FVC. DR was also calculated using Pst predicted from previously reported data. There was no significant group (lean vs. obese) by sex interaction or main effect of group on DR. However, women displayed significantly larger DR compared with men. Predicted Pst50FVC was significantly greater than measured Pst50FVC. DR calculated from measured Pst was significantly greater than when using predicted Pst. In conclusion, while obesity does not appear to alter airway size, women may have larger airways compared with men when mid-expiratory flow is maximal. Additionally, DR estimated using predicted Pst should be used with caution.

scholarly journals Aspirated Almond Masquerading as an Obstructing Endobronchial Mass Suspicious for Lung Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Sreeja Biswas Roy ◽  
Mitchell D. Ross ◽  
Nikhil Madan ◽  
Hesham Abdelrazek ◽  
Rebekah Edwards ◽  
...  
Keyword(s):  
Delayed Diagnosis ◽  
Lower Lobe ◽  
Needle Aspiration ◽  
Community Acquired Pneumonia ◽  
Left Lower Lobe ◽  
Smoking History ◽  
Delayed Presentation ◽  
Insidious Onset ◽  
Multiple Biopsies ◽  
History Of

Foreign body aspiration is relatively rare in adults compared to children. In adults with delayed presentation, a history of choking is often absent, resulting in delayed diagnosis and significant morbidity. Common presenting features in adults include nonresolving cough with or without fever, hemoptysis, or wheezing and may mimic infectious, inflammatory, or neoplastic disorders. We present a case of a 64-year-old man with 80-pack-year smoking history who had a nonresolving left lower lobe infiltrate on chest radiograph after treatment for community-acquired pneumonia. His insidious-onset symptoms included cough, decreased exercise tolerance, and localized wheezing. Computed tomography of the chest showed a left lower lobe consolidation, with narrowing of the bronchus. Flexible bronchoscopy revealed a fleshy endobronchial mass, prompting endobronchial needle aspiration and biopsies, all of which revealed acute inflammation on rapid onsite evaluation. After multiple biopsies, a white pearly object with a detached brown cover was revealed; the object was found to be an aspirated almond. The almond and its peel were retrieved. The patient acknowledged that he had frequently eaten almonds in the supine position while recovering from a previous injury. His symptoms completely resolved at 3-month follow up, and he has ceased smoking and no longer consumes food while supine.

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