Surgical outcome of combined pulmonary and atrial resection for lung cancer.

Objectives: The study was carried out to assess the short and long-term outcome of patients with non-small cell lung cancer infiltrating the left atrium treated by surgery.

Methods: We retrospectively collected the hospital files of twenty-three consecutive patients operated on between 1982 and 2001 in two units of Thoracic Surgery. Four patients received an induction regimen.

Spontaneous intercostal pulmonary hernia.

A case of spontaneous intercostal pulmonary hernia as a result of vigorous coughing is reported in a 67-year-old man. The great majority of acquired pulmonary hernias are post-traumatic; rare cases are spontaneous, resulting from prolonged and/or repeated increased intrathoracic pressure. This hernia was successfully repaired with a polyglactin absorbable mesh and approximation of the ribs with heavy stitches.

The modified "hemi-clamshell" approach for tumors of the cervicothoracic junction.

The anterior approaches proposed for treatment of the apical chest tumors (anterior transcervical, transmanubrial, and hemi-clamshell) have precise advantages and limits. To avoid these limits we have modified the hemi-clamshell with the resection of the first costal cartilage and the costoclavicular ligament. This allows a wider opening of the sternocostal flap, with safe control of the entire subclavian vessels as well as easier access to the T1 to T3 vertebral bodies and the posterior chest wall.

[The surgical treatment of nonpalpable breast carcinomas].

The wide-spreading use of mammography in clinical approach and in screening programmes contributed to a sensible modification in the population of patients affected by breast malignancies. A special increase has been recorded in non-palpable breast tumors. The Authors have analyzed a total of 135 patients with impalpable breast lesions during the period 1990-1997.

Expression of human CD44v6 in non-small-cell lung cancer.

Introduction: The CD44 is a membrane glycoprotein that functions as lymph node homing receptor in lymphocyte activation and is involved in homo- and heterotypic cell adhesion. In several tumor cell lines the expression of splice variants (CD44v6 and CD44v7) are correlated with the metastatic potential and confer an advantage in the early steps of the metastatic cascade. In our study we examined 35 cases of non-small-cell lung cancers (NSCLC) in order to detect the presence of CD44v6 and to compare its expression with the histologic type, degree of differentiation, stage of the tumor and survival of the patients.

The effect of dextran for hypothermic (10 degrees C) preservation of human fetal lung fibroblasts.

Background: Low-potassium (LP) solution with Dextran (Dx) improves lung preservation. Nevertheless, the role of Dx in simple cold storage is not established yet. This study was designed to investigate the relationship between molecular weight and concentration of Dx in LP solutions and its effects on cell viability after prolonged hypothermic preservation.

The effect of trehalose on human lung fibroblasts stored in euro-collins and low potassium dextran solutions.

Background: The research on lung preservation for transplantation is directed to synthesize a solution, in order to prolong the preservation period, thus avoiding the damage to lung tissues caused by ischemia. In recent years some in vivo experimental papers have been published, in which good results were obtained by adding trehalose, a non-reducing disaccharide able to stabilize the cell membrane, to the storage solutions.

Materials And Methods: In this study we have evaluated the effects on human lung fibroblasts of commonly used storage solutions like Euro-Collins (EC) and Low Potassium Dextran (LPD), in which trehalose has respectively replaced glucose (T-EC) or was added (LPD-T).

Pneumocytes type II ultrastructural modifications after storage in preservation solutions for transplantation.

Although lung transplantation represents a real therapeutic opportunity, the problem of preserving the organ for a prolonged period (> 10 h) still remains unsolved. Further studies are necessary to fully understand the behavior of different lung cell types during the ischemic period. As ultrastructural modifications of cells of lung samples stored in different means of preservation represent an index of the integrity and therefore of cellular viability, in the present work we have compared the time-related ultrastructural changes in human pneumocytes type II cells after hypothermic (10 degrees C) storage for 6 and 12 h in University of Wisconsin (UW) solution and in low potassium dextran (LPD) solution.

An original application of plasma expanders: heart-lung preservation.

The lack of an ideal heart-lung preservation solution is one of the principal factor that limits the wide spread of transplantation. The aim of this work was to investigate the efficacy of Haemaccel (HM) on isolated human pulmonary artery endothelial cells comparing its effects with those of University of Wisconsin (UWS). Subcultures of HPAEC were inoculated at the density of 5,000 cells per cm2 in 9 cm2 well-plates.

An effective solution for prolonged preservation of cultured human pulmonary artery endothelial cells.

Pulmonary endothelium is considered the compartment most susceptible to preservation damage. This investigation was designed to analyze the efficacy of an original, University of Parma low-potassium-albumin solution (SPAL UP) on cultured human pulmonary artery endothelial cells (HPAEC) and to compare its effects with those of University of Wisconsin solution (UW) and Euro-Collins solution (EC). Cryopreserved HPAEC tertiary cultures were inoculated at the density of 5000 cells/cm2 in 9-cm2 well-plates; subcultures were then incubated at 10 degrees C for 6 hr and 16 hr in 2 ml/well of SPAL UP, UW, and EC.

Primary pulmonary lymphoma: report of a case diagnosed by transbronchial biopsy.

Primary pulmonary lymphomas are uncommon tumours arising from mucosa associated lymphoid tissue (MALT). The authors report a case diagnosed by transbronchial biopsy and treated by surgery only. They discuss the distinct clinicalpathological features and debate the different ways of treating this condition.

Electromyographic evaluation of the spared serratus anterior after postero-lateral thoracotomy.

Postero-lateral thoracotomy is the standard access in thoracic surgery, and can be carried out dividing or preserving the serratus anterior muscle. This last method, besides its advantages, is still a matter of discussion, in fact traction has been claimed to cause severe muscular damage equal to section. We have studied 20 patients (16 males and 4 females, mean age 63 years), who underwent postero-lateral thoracotomy sparing the serratus anterior, after 6 months from surgery, both clinically and by means of electromyography (EMG), to evaluate the functional status of the spared muscles.

Leiomyosarcoma of the superior vena cava.

Leiomyosarcoma of the superior vena cava is exceptional. A case in a 52-year-old man is described. A treatment by means of neoadjuvant chemotherapy, operation, and adjuvant radiotherapy was performed.

Morphological changes of human pulmonary-artery endothelial cells after 12-hours hypothermic storage in organ-preservation solutions.

Pulmonary endothelial cells are known to be fundamental for lung preservation and one of the most serious limiting factors observed during transplantation is the stress to which these cells are subjected. On this premise, strenuous efforts should be made to select and employ the preservation solution best able to prolong ischemia time and thus prevent cytotoxic effects. The aim of this study was to identify the solution with minimum toxicity on endothelial cells.

An uncommon indication for tracheal resection.

In well selected cases, in which preoperative investigations allow us to plan a tracheal resection-anastomosis, surgery is the best current treatment also for secondary tumours involving the trachea. We report a case of a patient suffering from severe dyspnoea for tracheal stenosis due to recurrence of an epidermoid cancer of the tongue. Surgical treatment allowed us to obtain very good palliation.

Methodology for the assessment of lung protection. Human pulmonary artery endothelial cell preservation using haemaccel.

This investigation was designed to show an original methodology for the assessment of lung preservation and to analyze the efficacy of a low potassium polygelin solution (haemaccel [HM]) on isolated human pulmonary artery endothelial cells. The effects of HM were compared with those of low potassium dextran (LPD), Belzer (University of Wisconsin [UWS]), and Euro-Collins solutions. The viability of the endothelial cultures was assessed by means of both total protein content and recovery of metabolic cellular function expressed as the protein synthesis rate after 6 hr and 16 hr of incubation at 10 degrees C.

Pulmonary endothelial cell modifications after storage in solid-organ preservation solutions.

During lung preservation, the vascular endothelium is probably the first site of damage and these lesions are considered the main limiting factor in solid-organ preservation. In the present study, the ultrastructural changes in the endothelial cells of human pulmonary artery hypothermically stored (at 4 degrees C) for 6 and 12 h in Euro-Collins, University of Wisconsin and Ringer-lactate solutions were compared. The arteries obtained from three patients who underwent pneumonectomy were divided into 20 segments and preserved in the three solutions mentioned.

Late spontaneous chylopericardium following complex cardiac surgery.

Chylopericardium as an isolated complication after open heart surgery is a rare event. We present here a case of late postoperative chylopericardium and comment on the clinical course, the aetiopathology and treatment.

Ultrastructural damage of the pulmonary endothelial cell after storage in lung preservation solutions. Comparison between Belzer and Euro-Collins solutions.

Unlabelled: The preservation of the lung for transplantation for a long period is still a problem not solved. Euro-Collins (EC) and Belzer (UW) solution are the most widely used. The aim of this work is to analyse the direct influence of both EC and UW solutions on endothelial cells of human pulmonary artery by means of an ultrastructural analysis.