Circulatory effects of dexmedetomidine in early sepsis: a randomised controlled experimental study.

We designed this experimental study with a view to evaluate the effects of dexmedetomidine (DEX) on cardiac performance and systemic and peripheral hemodynamics in healthy and early-stage endotoxemia swine models. Our study hypothesis was that DEX can ensure hemodynamic stability during the course of endotoxemia. Thirty-two male pigs (25-27 kg) were assigned into four groups: (1) no intervention (group A), (2) DEX 0.

Chest wall lipoblastoma in a 3 year-old boy.

Background: Lipoblastoma is a rare, benign, fatty tissue tumor that occurs in infancy and early childhood. The most common tumor locations are the extremities and the torso. The location of this tumor in the chest wall and an intrathoracic extension is uncommon.

Successful treatment of familial congenital chylothorax by ligation of the thoracic duct: A case report.

A full term boy was admitted with respiratory distress in the fourth week of his life due to spontaneous chylothorax in his right hemithorax. Spontaneous chylothorax occurred previously in a first cousin of the neonate establishing that way the final diagnosis of familial idiopathic congenital pneumothorax. Failure of the conservative treatment consisting of chest tube drainage, discontinuation of oral diet and administration of total parenteral nutrition in combination with octreotide for one month was followed by the successful ligation of the thoracic duct through a right thoracotomy.

Massive chest wall resection and reconstruction for malignant disease.

Objective: Malignant chest wall tumors are rare neoplasms. Resection with wide-free margins is an important prognostic factor, and massive chest wall resection and reconstruction are often necessary. A recent case series of 20 consecutive patients is reported in order to find any possible correlation between tumor histology, extent of resection, type of reconstruction, and adjuvant treatment with short- and long-term outcomes.

Repair of post-intubation tracheoesophageal fistulae through the left pre-sternocleidomastoid approach: a recent case series of 13 patients.

Objective: Post-intubation tracheoesophageal fistula (TEF) is a late complication of tracheotomy, while membranous trachea laceration during percutaneous dilational tracheostomy is implicated in the generation of early post-tracheotomy TEF. Surgical repair is the only viable option for these patients and the technique of repair depends on a variety of factors.

Methods: Totally 13 patients (mean age: 54.

Magnetic connectors for coronary surgery: what do we know a decade later?

In 2001, a novel sutureless magnetic anastomotic device (MVP) for coronary anastomosis was introduced in Europe for both on-pump and off-pump procedures. The device has been implanted in more than 150 patients with encouraging short-term but less favorable mid-term results. However, to date long-term patency outcomes of those recipients have not been investigated.

Early reoperation performed for the management of complications in patients undergoing general thoracic surgical procedures.

Objective: To detect the rate and predisposing factors for the development of postoperative complications requiring re-operation for their control in the immediate postoperative period.

Methods: During the time period 2009-2012, 719 patients (male: 71.62%, mean age: 54±19 years) who underwent a wide range of general thoracic surgery procedures, were retrospectively collected.

Treatment of infected thoracic aortic prosthetic grafts with the in situ preservation strategy: a review of its history, surgical technique, and results.

For cardiothoracic surgeons prosthetic graft infection still represents a difficult diagnostic and treatment problem to manage. An aggressive surgical strategy involving removal and in situ replacement of all the prosthetic material combined with extensive removal of the surrounding mediastinal tissue remains technically challenging in any case. Mortality and morbidity rates following such a major and risky surgical procedure are high due to the nature of the aggressive surgical approach and multi-organ failure typically caused by sepsis.

Adjuvant chemotherapy and radiotherapy in the treatment of non-small cell lung cancer (NSCLC).

Lung cancer is one of the most common human malignancies and remains the leading cause of cancer related deaths worldwide. Many recent technological advances led to improved diagnostics and staging of lung cancer. With development of new treatment options such as targeted therapies there might be improvement in progression free survival of patients with advanced stage non-small cell lung cancer (NSCLC).

Advanced bronchoscopic techniques in diagnosis and staging of lung cancer.

The role of advanced brochoscopic diagnostic techniques in detection and staging of lung cancer has steeply increased in recent years. Bronchoscopic imaging techniques became widely available and easy to use. Technical improvement led to merging in technologies making autofluorescence or narrow band imaging incorporated into one bronchoscope.

Superior sulcus (Pancoast) tumors: current evidence on diagnosis and radical treatment.

Pancoast tumors account for less than 5% of all bronchogenic carcinomas. These tumors are located in the apex of the lung and involve through tissue contiguity the apical chest wall and/or the structures of the thoracic inlet. The tumors become clinically evident with the characteristic symptoms of the "Pancoast-Tobias syndrome" which includes Claude-Bernard-Horner syndrome, severe pain in the shoulder radiating toward the axilla and/or scapula and along the ulnar distribution of the upper arm, atrophy of hand and arm muscles and obstruction of the subclavian vein resulting in edema of the upper arm.

Pericardial patch tracheoplasty for the repair of a long, multisegmental postintubation tracheal damage.

A 64-year-old man was admitted with a postintubation, multisegmental tracheal damage comprising of two stenotic lesions, below and above a tracheotomy. The patient underwent resection of the damaged anterolateral tracheal wall through a combined collar-cuff and median sternotomy incision and tracheoplasty with autologous pericardium around a Silastic T-tube that was fixed to the cricoid cartilage, healthy distal trachea, and the remaining membranous wall. The postoperative period was complicated with a deep sternal wound infection that was successfully treated with vacuum-assisted closure for 2 weeks.

A modified two-port thoracoscopic technique versus axillary minithoracotomy for the treatment of recurrent spontaneous pneumothorax: a prospective randomized study.

Background: Currently, most thoracic surgeons perform surgical pleurodesis for recurrent spontaneous pneumothorax (RSP) by video-assisted thoracic surgery (VATS). However, the superiority of VATS over axillary minithoracotomy is not been established in prospective studies to date. A modified two-port VATS technique and axillary minithoracotomy were prospectively evaluated for possible differences in the short- and long-term outcome for patients.

The management of post-intubation tracheal stenoses with self-expandable stents: early and long-term results in 11 cases.

Objective: The optimal management of post-intubation tracheal stenoses is surgical reconstruction of the airway. Stenting of the trachea using silastic T-tubes or one of the various types of tracheal stents are the alternative ways to surgical reconstruction for the management of post-intubation tracheal stenoses. The early and long-term results of 11 patients with post-intubation tracheal stenosis, who underwent tracheal stenting with self-expandable metallic stents (SEMSs), are presented.

Intraoperative infusion of S(+)-ketamine enhances post-thoracotomy pain control compared with perioperative parecoxib when used in conjunction with thoracic paravertebral ropivacaine infusion.

Objective: The authors explored the use of continuous postoperative subpleural paravertebral ropivacaine alone combined with intraoperative S(+)-ketamine or perioperative parecoxib as a new approach to pain control after major thoracotomy.

Design: A randomized study.

Settings: A single university hospital.

Prenatal interventional and postnatal surgical therapy of extralobar pulmonary sequestration.

Extralobar sequestration, a discrete developmental mass of pulmonary parenchyma which is enclosed within a separate pleural envelope and has its own vascular supply, is recently diagnosed prenatally by ultrasonography. We report two male newborn babies, 10 days old, who prenatally underwent amnioperitoneal shunt, pleural drainage and laser ablation of the feeding artery. Both babies underwent thoracotomy on their 10th day of life, removal of the sequestration, ligation of the feeding vessel which remained patent despite laser treatment in the first case and drainage of a large pleural effusion in the second case.

Schwannoma of the vagus nerve, a rare middle mediastinal neurogenic tumor: case report.

Schwannoma originating from the vagus nerve within the mediastinum is a rare, usually benign tumor. A 44-year old male was presented with chest pain. Chest radiography, CT scan and MRI showed a well circumscribed mass, 5 x 4 cm located in the aortopulmonary window.

Serum levels of matrix metalloproteinases -1,-2,-3 and -9 in thoracic aortic diseases and acute myocardial ischemia.

Background: Matrix metalloproteinases (MMPs) constitute a family of zinc-dependent proteases (endopeptidases) whose catalytic action is the degradation of the extracellular matrix components. In addition, they play the major role in the degradation of collagen and in the process of tissue remodeling. The present clinical study investigated blood serum levels of metalloproteinases- 1, -2, -3 and -9 in patients with acute and chronic aortic dissection, thoracic aortic aneurysm and acute myocardial ischemia compared to healthy individuals.

Primary intrathoracic goiter: a rare and potentially serious entity.

Background: Here we review primary intrathoracic goiter (P-ITG), a rare but potentially serious congenital entity that is distinct from the much more common secondary intrathoracic goiter. The latter is an extension of cervical thyroid that descends within the mediastinum. In contrast, P-ITGs lack a connection with the cervical thyroid and their blood supply comes from intrathoracic vessels.

A rare tumoral combination, synchronous lung adenocarcinoma and mantle cell lymphoma of the pleura.

Background: Coexistence of adenocarcinoma and mantle cell lymphoma in the same or different anatomical sites is extremely rare. We present a case of incidental discovery of primary lung adenocarcinoma and mantle cell lymphoma involving the pleura, during an axillary thoracotomy performed for a benign condition.

Case Presentation: A 73-year old male underwent bullectomy and apical pleurectomy for persistent pneumothorax.