Therapeutic bronchoscopy followed by sequential radiochemotherapy in the management of life-threatening tracheal adenoid cystic carcinoma: a case report

Role of Flexible Bronchoscopy using Biopsy Forceps as the Initial Attempt for Headscarf Pin Aspiration Extraction

Introduction

Flexible bronchoscopy is a less invasive procedure for extracting foreign bodies from the airways. However, studies on the extraction of headscarf pins are still very limited to determine the efficacy and safety of headscarf pin extraction using flexible bronchoscopy with biopsy forceps.

Methods

This retrospective study was conducted at Persahabatan Hospital, Jakarta, Indonesia, on patients who had been treated in this hospital for headscarf pin extraction between January 2013 and February 2023. Fibreoptic bronchoscopy was performed under general anaesthesia. The pin was removed using Radial Jaw 4 mm single-use pulmonary biopsy forceps. The impacted sharp tip of the pin was freed first, and the proximal part of the pin body was gripped using biopsy forceps. Once a firm hold of the sharp end or the proximal part of the pin was secured, the bronchoscope and forceps were both slowly withdrawn under direct vision.

Results

Thirty-two cases with headscarf pin aspiration were managed by fibreoptic bronchoscopy. A total of 12 patients (37.5%) came without any respiratory complaints; however, an equal number complained of cough and 6 cases (18.7%) of haemoptysis. All the cases in which the pins were visible in the airway were found with the round head down and the sharp tip oriented superiorly in the airway and impacted in the mucosa. Fibreoptic bronchoscopy extraction succeeded in 31 cases (96.8%). Only one case was converted to surgery. There were no major complications.

Conclusion

Fibreoptic bronchoscopy with biopsy forceps under general anaesthesia is safe and effective for the removal of headscarf pin aspiration.

Bronchoscopy Laser and Silicone Y-Stents as Emergency Airway Management in Central Airway Stenosis Due to Secondary Thyroid Carcinoma: A Case Report

Total airway obstruction in thyroid cancer is rare and has high morbidity and mortality. Airway management in such cases is challenging, especially in cases in which thyroid masses cannot be totally resected. It is important to choose the appropriate airway treatment modality. Currently, therapeutic rigid bronchoscopy procedures and endoluminal lasers, as well as airway stent insertion, are a management modality of near-total malignant airway obstruction. We report a rigid bronchoscopy procedure combined with laser and Y-stent silicone insertion in thyroid cancer with extension infiltration, as well as compression in the trachea covering the subglottic tracheal area up to the main carina and tracheo-bronchomalacia, manifesting as acute respiratory failure.

Biosorption of Neodymium (Nd) from Aqueous Solutions Using Spirulina platensis sp. Strains

Rare earth elements such as neodymium (Nd) are important elements used mainly in developing new technologies. Although they are found in low concentrations in nature, they can be obtained by extracting solid samples such as phosphogypsum. Among the techniques, adsorption has been used successfully with several adsorbent materials. In this work, two strains of Spirulina platensis (LEB-18 and LEB-52) were employed as biosorbents for efficiently removing the Nd element from the aqueous media. Biosorption tests were carried out in a batch system, and the results of the biosorption kinetics showed that for both materials, the biosorption of Nd was better described by the Avrami model. Moreover, it could be considered that 80 min would be necessary to attain the equilibrium of Nd(III) using both biosorbents. The result of the biosorption isotherms showed that for both strains, the best-fitted model was the Liu model, having a maximum biosorption capacity of 72.5 mg g−1 for LEB-18 and 48.2 mg g−1 for LEB-52 at a temperature of 298 K. Thermodynamics of adsorption showed that for both LEB-18 and LEB-52 the process was favorable (∆G° < 0) and exothermic (∆H° −23.2 for LEB-18 and ∆H° −19.9 for LEB-52). Finally, both strains were suitable to uptake Nd, and the better result of LEB-18 could be attributed to the high amount of P and S groups in this biomass. Based on the results, a mechanism of electrostatic attraction of Nd3+ and phosphate and sulfate groups of both strains of Spirulina platensis was proposed.