Surgical thoracic sympathectomy induces structural and biomechanical remodeling of the thoracic aorta in a porcine model.

Background: Sympathetic innervation exerts marked effects on vascular smooth muscle cells, including a short-term homeostatic (vasoconstrictor) and a direct trophic action promoting differentiation. However, the role of sympathetic nervous system in long-term structural and functional modulation of the aortic wall is yet undefined.

Methods: Six Landrace pigs underwent bilateral thoracic sympathectomy from the stellate to T8 ganglion, whereas 10 pigs underwent sham operation.

Malignant pleural effusion and talc pleurodesis. Experimental model regarding early kinetics of talc particle dissemination in the chest after experimental talc pleurodesis.

Purpose: Talc remains a commonly used agent for pleurodesis malignant pleural effusion. Nevertheless, it is associated with a 3-9% incidence of pulmonary reactions ranging from simple pneumonitis to acute respiratory distress syndrome (ARDS). The underlying lung pathology and the size and rate of talc particle dissemination have been implicated as the cause of these complications.

The effects of hypothyroidism on the mechanical properties and histomorphological structure of the thoracic aorta.

This experimental study investigates the effects of hypothyroidism on the descending thoracic aorta. Hypothyroidism was induced in 20 male Wistar rats by administering 0.05% of 6-n propyl 2-thiouracil (PTU) in their drinking water for 8 weeks.

Hypothyroidism and the aorta. evidence of increased oxidative DNA damage to the aorta of hypothyroid rats.

Background: Although it has been suggested that the hypometabolic state is associated with a decrease in oxidative stress, literature data are controversial, revealing an individuality of oxidant status in relation to tissue properties and responsiveness. Hypothyroidism has profound direct and indirect actions on the vascular system, inducing characteristic hemodynamic changes while the aorta represents an important determinant of vascular performance. This study aims to examine the oxidant status on the aorta in chronic experimental hypothyroidism.

Does anemia affect outcome after lobectomy or pneumonectomy in early stage lung cancer patients who have not received neo-adjuvant treatment?

Background: Preoperative anemia has been shown to be an ominous prognostic factor for survival in patients with early stage non small cell lung cancer.

Methods: Two hundred and fourteen patients underwent resection for early stage non small cell lung cancer between 2001 and 2006 without neo-adjuvant treatment. Patients were divided into four groups based on their admission hemoglobin (Hgb): group I: Hgb < or = 12 g/dl, group II: Hgb = 12.

Hyperthyroidism is associated with increased aortic oxidative DNA damage in a rat model.

Background: Hyperthyroidism is associated with increased oxidative stress and oxygen free radical production. Oxygen free radicals are implicated in several signalling pathways leading to vascular pathology. The present study evaluates the extent of aortic oxidative stress in experimental hyperthyroidism.

Thorough clinical investigation of low cardiac output syndrome after subxiphoid pericardiostomy.

The paradoxical hemodynamic response after surgical or catheter pericardial drainage for cardiac tamponade is an infrequent complication. This case report describes this occasional ominous consequence of surgical pericardial decompression and suggests possible physiological explanations of rapidly progressive heart failure and death.

Independent predictors for early and midterm mortality after thoracic surgery.

Background: The purpose of the present study was to determine independent predictors for early and midterm mortality for the whole context of thoracic surgery.

Methods: We studied 1453 consecutive patients who underwent thoracic surgery between 2002 and 2005. Operations included lung resections (n = 504), mediastinal (n = 468), pleural and pericardial (n = 226), esophageal (n = 83), chest wall (n = 85), tracheal (n = 50) and other procedures (n = 37).

The mechanical performance and histomorphological structure of the descending aorta in hyperthyroidism.

Thyroid hormones decrease systemic vascular resistance by directly affecting vascular smooth muscle relaxation. There is limited literature about their effect on the mechanical performance of the aortic wall. Therefore, the authors determined the influence of hyperthyroidism on the mechanical properties and histomorphological structure of the descending thoracic aorta in rats.

Surgical management of mediastinal lesions.

Mediastinal tumors and cysts are relatively uncommon lesions requiring histologic confirmation. This retrospective study reports the experience of our department in the diagnosis and treatment of mediastinal lesions. Mediastinal lesions that were surgically treated in 200 patients aged 6-84 years, during a period of 28 years, were included in this series.

Post-vagotomy mechanical characteristics and structure of the thoracic aortic wall.

This study assessed the long-term effect of vagotomy on the structure and passive mechanical characteristics of the thoracic aorta under a wide range of stresses in vitro. Eight healthy Landrace pigs underwent bilateral vagotomy distal to the origin of the recurrent laryngeal nerve, and 10 pigs were sham-operated. Three months post-surgery, the aorta was excised and specimens from the ascending aorta, arch, and descending thoracic aorta were subjected to histomorphometrical evaluation and uniaxial tensile-testing until failure.

Multimodality treatment of neuroendocrine tumors of the thymus.

Background: Neuroendocrine tumors of the thymus are rare neoplasms. Four patients with this tumor who underwent multimodality treatment are presented and the literature is briefly reviewed.

Methods: The medical records of all patients treated for neuroendocrine tumors of the thymus from 1979 to 2002 were reviewed.

Topographic anatomy of bronchial arteries in the pig: a corrosion cast study.

The anatomy of porcine bronchial circulation has not been fully described. The purpose of this study was to investigate the extrapulmonary topographic anatomy of bronchial arteries in pig. Ten pigs weighing 15-25 kg were studied.

Cervical mediastinoscopy and anterior mediastinotomy in superior vena cava obstruction.

Study Objectives: There is general agreement regarding the diagnostic efficacy of cervical mediastinoscopy (CMDS) and anterior mediastinotomy (AMDT) on patients with superior vena cava obstruction (SVCO), but controversy exists concerning the safety of these two diagnostic methods on that particular subset of patients. The purpose of the present study is to evaluate the safety and diagnostic efficacy of CMDS and AMDT in patients with SVCO.

Materials And Methods: During the last 28 years, 39 consecutive patients with SVCO underwent biopsy of mediastinal lesions by CMDS (n = 18) or AMDT (n = 19) or both these techniques (n = 2).

Prognostic factors in thymic epithelial tumors undergoing complete resection.

Background: The prognostic factors in thymic epithelial tumors (TET) are investigated within a 27-year period in 104 patients submitted to surgical and pathologic complete resection of TET with a mean age of 53 +/- 14.6 years and a male to female ratio of 0.73.

Presternal gastric bypass for late postpneumonectomy esophagopleural fistula.

A 71-year-old diabetic patient underwent right pneumonectomy with wide mediastinal lymph node dissection for lung cancer (right upper lobe). Postoperatively he developed pleura empyema that was successfully treated - drainage and Eloesser window, followed by adjuvant radiotherapy. Two months later he developed an esophagopleural fistula.

Myoplasty versus omentoplasty in the surgical treatment of hydatidosis of the liver dome.

Background And Aims: Even though surgery is the mainstay in the management of hydatid disease of the liver, controversies still exist about the preferred operating technique. This study was conducted to evaluate myoplasty versus omentoplasty for the surgical treatment of hepatic dome hydatidosis.

Patients And Methods: Sixty-two patients with a hydatid cyst located over the right superior-posterior part of the liver or a cyst adherent to the right hemidiaphragm were classified into two groups according to the type of surgical approach.

AIDS-related cardiac tamponade: is surgical drainage justified?

In order to evaluate the usefulness of surgical drainage in the treatment of patients with acquired immunodeficiency syndrome (AIDS)-related cardiac tamponade, we reviewed our experience with subxiphoid pericardiostomy on 5 consequent such patients. One patient died in the immediate postoperative period and the remaining 4 died within 21 weeks after the operation. Similar results have been reported by other authors who found that surgical drainage has no diagnostic or therapeutic benefit over pericardiocentesis in this particular group of patients.

Pleuropulmonary blastoma in childhood. A malignant degeneration of pulmonary cysts.

Pleuropulmonary blastoma (PPB) is an extremely rare intrathoracic neoplasm of early childhood with an unfavorable outcome. In this article, two children with PPB associated with pre-existing pulmonary cysts are presented. It is emphasized that surgical excision is the treatment of choice for all pulmonary cysts.

Pyothorax-associated lymphoma (PAL): a western case with marked angiocentricity and review of the literature.

Aims: To report a case of pyothorax-associated lymphoma in a non-immunocompromised 78-year-old man with a 45-year history of tuberculous pleuritis and left pleural effusion. Pyothorax-associated lymphoma is a high-grade non-Hodgkin's lymphoma occurring in 2% of patients with long-standing tuberculous pleuritis and pyothorax. Pyothorax-associated lymphoma is frequently Epstein-Barr virus (EBV)-associated, mainly reported in Japan but exceedingly rare in western countries.

Pedicled myocutaneous and muscle flaps in the management of complicated cardiothoracic problems.

The purpose of this study was to review our experience with the management of patients with complicated cardiothoracic problems by the use of pedicled myocutaneous or muscle flaps, and discuss the various methods of reconstruction. Over the last 11 years, we have treated 54 patients with complicated cardiothoracic problems by reconstruction with pedicled myocutaneous or muscle flaps. The underlying causes were chest wall tumours (n = 13), radionecrosis of the chest wall (n = 12), deep or chronic sternal infections (n = 25), and bronchopleural fistulas (n = 4).

Risk factors affecting the survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy.

Study Objectives: Surgical subxiphoid drainage of the pericardial cavity has been established as a safe and effective method of treatment of pericardial effusion; however, the risk factors affecting survival of these patients have not been clarified. The aim of this study was to investigate the risk factors affecting the short-term and long-term survival of patients with pericardial effusion submitted to subxiphoid pericardiostomy.

Design: Retrospective study.

Surgical treatment of esophageal perforation.

Background/aims: In spite of the progress made during the last few decades, esophageal perforation continues to carry a serious prognosis. The aim of this study is to present our experience with surgical treatment of esophageal perforation.

Methodology: Eight patients with esophageal perforation were submitted to surgical treatment with varying time intervals between the perforation and the operation.