What is bronchoscopy?

The lungs are host to many diseases, like tuberculosis, cancer, pneumonia, asthma, etc. In order to treat them properly, specialized diagnostic tests are required – bronchoscopy is one such test. It involves the insertion of a flexible endoscope or bronchoscope through either the mouth or the nose into the lungs and the respiratory system. The bronchoscope is connected to a camera and monitor to visualize the interior of the lungs. One can see various abnormalities like cancer growths, bleeding spots, foreign bodies, etc. Additionally, the bronchoscope is hollow – like a pipe – through which special instruments can be passed in order to take pieces (called biopsies) from abnormal areas seen inside. These pieces or biopsies are then studied under the microscope for proper and accurate diagnosis of various diseases.

Various types and sizes of bronchoscopes are available for all ages and diseases. One of the new type is called an Endo bronchial ultrasound bronchoscope or an EBUS scope. The EBUS scope has an ultrasound transducer built-in into the tip of the scope – which is the end that goes into the lungs. With the help of the ultrasound the internal structures can be accurately imaged and all biopsies taken directly under guidance of the ultrasound. This increases the safety, accuracy and yield of the procedure.

The diseases which usually need bronchoscopy for diagnosis include lung cancer, sarcoidosis, some types of tuberculosis, interstitial lung disease (lung shrinkage), etc. Another important use is the removal of foreign bodies especially in children.

Liberia to receive Zmapp drug to treat Ebola virus

In a new development, Liberia is likely to try out an experimental drug 'ZMAPP' for the current Ebola outbreak without the requisite human trials.  Read the previous post for more information.

Link for current post: Liberia to receive Zmapp drug to treat Ebola virus

Miracle drug for EBOLA

Two health care professionals suffering from EBOLA virus infection were miraculously saved by an experimental drug. Importantly, the drug, known as 'ZMapp' , had only been tested in animals till now! Talk about miracles.

You can read the whole story here:  http://edition.cnn.com/2014/08/04/health/experimental-ebola-serum/

"Lung dialysis"

Some things are beyond belief, though clearly plausible - as the following example illustrates.

     A male patient in the US suffering from cystic fibrosis underwent a double lung transplant followed by failure. He was posted for re-transplant but was told that his carbon dioxide levels were too high. However, his physician, who was a well read man and in contact with the bioengineering world decided to go in for something out of the ordinary. A sort of a mini ECMO machine had been developed a few years earlier, for removing carbon dioxide from the lung. Known as the Hemolung RAS, it functions by removing carbon dioxide from and adding oxygen to blood just like a dialysis machine. As it was not approved by the FDA, emergency approval was taken within 24 hrs and the patient put on the machine. Lo and behold, he improved, the carbon dioxide levels reduced to acceptable limits and he was taken up for retransplant!

Some salient points:

1. Cystic fibrosis is a sort of death sentence in general practice in India with only symptomatic treatment available
2. This patient underwent double lung transplant not once but twice
3. Emergency approval applied for and recieved within 24 hours!! (Seems like some sort of dream)
4. As the machine was not available in the US, the doctors incharge personally acquired it from across the border i.e. Canada
5. The patient remained for 20 days on the machine
6. The machine was not recommended for use by any professional society

Lessons:

1. Out of the box thinking is the key
2. Be uptodate in one's field
3. Persistence and perseverance are essential

The full article can be read here: http://medicalxpress.com/news/2014-07-patient-implanted-hemolung-lifesaving-lung.html

Thanks to Dr.Ajay Handa for updating me on this.