Left innominate vein wrapping with Dacron sheath after thymectomy.

Background: Any type of radical thymectomy, open or thoracoscopic, always results in a skeletonized left innominate vein (LIV), which is highly expected to form adhesions to the posterior surface of the sternum. Therefore, in case of future sternotomy, the LIV remains highly exposed to trauma.

Methods: We describe a surgical technique that is expected to protect the innominate vein in case of future sternotomy.

Stage-II thymoma and emergency coronary artery bypass. To irradiate or not to irradiate to avoid radiation induced vascular injury? Case report and literature review.

Purpose: The purpose of this study was to present the controversial role of adjuvant radiotherapy to a 72-year-old male patient with Masaoka stage II thymoma and coronary artery bypass and to review the relevant literature.

Methods: The data were collected by relevant studies on PubMed and EMBASE. Articles up to March 2017 were included.

Surgical Management of Non-small Cell Lung Cancer with Solitary Hematogenous Metastases.

Background/aim: The treatment of patients with solitary hematogenous metastases from non-small cell lung cancer (NSCLC) remains controversial, although numerous retrospective studies have reported favorable results for patients offered combined surgical therapy. Our aim was to determine the role of surgical resection in the management of NSCLC with solitary extrapulmonary metastases and to investigate for possible prognostic factors.

Patients And Methods: Between January 2004 and December 2012, 12 patients with NSCLC, from two Institutions, underwent metastasectomy for their solitary metastatic lesion.

Sternotomy following minimally invasive thoracoscopic procedures: a word of caution.

An increasing number of patients with previous minimally invasive thoracic procedures for anterior mediastinal tumors are now requiring cardiac surgery. This paper highlights the potential damage that can occur when standard sternal splitting techniques are used in these patients.

"Directed" cardioplegia: a new approach in myocardial protection in left main coronary artery disease.

"Directed cardioplegia" is a novel approach in myocardial protection in which a certain volume of cardioplegic solution is diverted into a severely diseased coronary artery after surgical occlusion of the other main branches that can be accessed by the surgeon. In this way, the surgeon is able to eliminate the cardioplegic steal from a severely stenosed vessel through other less severely diseased and/or patent arteries during the nonselective antegrade administration of cardioplegia and to protect myocardial regions, which are poorly perfused. We performed this new technique in 2 patients with severe left main coronary artery disease with excellent results.

WITHDRAWN: Tropical plant needle: cause of unknown recurrent tamponade.

This article has been withdrawn consistent with Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy).

Heparin induced thrombocytopenia diagnosis in cardiac surgery: is there a role for thromboelastography?

The aim of the present protocol is to investigate the potency of thromboelastography (TEG) to screen postcardiac heparin induced thrombocytopenia (HIT) patients suspicious for HIT type II, and to differentiate which of them are subject to suffer thrombotic complications from those who will suffer hemorrhagic complications.

Can thromboelastography predict which patients with heparin-induced thrombocytopenia may suffer thrombotic complications of type II?

Despite the existence of several sensitive functional and antigen assays used for the diagnosis of heparin-induced thrombocytopenia (HIT), an additional assessment of the patient's hemostatic status, in order to predict the thrombotic complications of the malevolent HIT type II, has become necessary. Herein below, we present the findings of thromboelastography (TEG) in a post-cardiac-surgery patient with the clinical diagnosis of HIT type II and false negative tests for heparin antibodies. We have reached the conclusion that TEG may prove to be a useful supplementary method to predict those HIT patients who may suffer complications of HIT type II.

Retrograde cardioplegia in CABG: is it really useful? The microcirculation and a capillary unit model.

Most surgeons, ourselves including, use retrograde cardioplegia in numerable operations in cardiac surgery. It is believed to be not only supplementary to antegrade, but also a unique alternative in special complicated cases. Regarding CABGs (coronary artery bypass grafts), many authors advocate its routine use together with antegrade, while others do not suggest it for standard practice.

A huge posteromedial mediastinal cyst complicated with vertebral dislodgment.

Background: Mediastinal cysts compromise almost 20% of all mediastinal masses with bronchogenic subtype accounting for 60% of all cystic lesions. Although compression of adjoining soft tissues is usual, spinal complications and neurological symptoms are outmost rare and tend to characterize almost exclusively the neuroenteric cysts.

Case Presentation: A young patient with intermittent, dull pain in his back and free medical history presented in the orthopaedic department of our hospital.

Spontaneous rupture of the colon sigmoid following spontaneous recurrent pneumothorax in a patient with Marfan syndrome.

Background: Spontaneous ruptures of the colon and rectum are very rare clinical entities and always require laparotomy. In such cases, despite meticulous exploration an underlying pathology cannot be revealed and most reports in the world literature relate spontaneous colon ruptures with unusual connective tissue disorders such as Marfan or Ehlers-Danlos syndrome. Connective tissue diseases affect the structure and the synthesis of elastin and type III collagen, resulting in various systemic disorders.

Sigmoid schwannoma: a rare case.

Schwannomas are rare tumors derived from the cells of Schwann that form the neural sheath. When located in the gastrointestinal tract, they constitute together with leiomyoma, leiomyoblastoma, and leiomyosarcoma, the gastrointestinal stromal tumors (GIST). Peripheral nerve sheath tumors represent 2-6% GIST with most common location, the stomach and the small intestine.

Treatment of iatrogenic injury of membranous trachea with intercostal muscle flap.

Iatrogenic injuries of the membranous trachea are rare but potentially lethal, and most commonly require surgical treatment. Such injuries occur intraoperatively during specific thoracic surgery procedures or are associated with endotracheal anesthesia. Special technical difficulties in managing them surgically are encountered when lacerations are in proximity to the rigid rings of the trachea because of the lack of membranous tissue distal to the tear.

The effect of nitric oxide synthases inhibitors on inflammatory bowel disease in a rat model.

Background/aims: Overexpression of nitric oxide (NO) has been implicated in the pathogenesis of experimental and clinical inflammatory bowel disease (IBD). NO is produced by two types of enzymes: constitutively expressed and inducible NO synthases (NOS). This study assessed N(W)-nitro-L-arginine methyl ester (L-NAME) and aminoguanidine (AMG), the most studied inhibitors of nitric oxide synthases, with regard to their effectiveness as modulators of inflammation in trinitrobenzene sulfonic acid (TNBS)-induced colitis in the rat.