Penetrating thoracic injury with retained foreign body: can video-assisted thoracic surgery take up the leading role in acute management?

Video-assisted thoracic surgery (VATS) is widely adopted in acute management of patient with thoracic trauma, but its use in penetrating thoracic injuries with retained foreign bodies were rarely reported. We described three of such cases using VATS as the first line approach. Identification of injuries, control of bleeders, clot evacuation, resection of damaged lung parenchyma and safe retrieval of foreign bodies were all performed via complete VATS within short operative time.

Mitral valve repair using a semirigid ring: patient selection and early outcomes.

Background: Commonly used complete mitral annuloplastic rings include saddle-shaped and semirigid rings, with no clear indication for either type. A semirigid ring may be preferred in patients whose native mitral saddle shape is well maintained. We present our experience of using semirigid rings for mitral valve repair.

Tumorigenesis of smoking carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone is related to its ability to stimulate thromboxane synthase and enhance stemness of non-small cell lung cancer stem cells.

Lung cancer stem cells (LCSCs) play a critical role in lung cancer development, however, it is unknown whether thromboxane synthase (TXS) plays a role in the maintenance of LCSCs stemness. This study aimed to determine the in vivo role of TXS in lung cancer induced by 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), a smoking carcinogen. Results showed that ozagrel, a TXS blocker, suppressed NNK-induced lung tumors in mice.

Antineoplastic effects of 15(S)-hydroxyeicosatetraenoic acid and 13-S-hydroxyoctadecadienoic acid in non-small cell lung cancer.

Background: Previous studies have shown that the levels of 15-lipoxygenase 1 (15-LOX-1) and 15-LOX-2 as well as their metabolites 13-S-hydroxyoctadecadienoic acid (13(S)-HODE) and 15(S)-hydroxyeicosatetraenoic acid (15(S)-HETE) are significantly reduced in smokers with non-small cell lung carcinoma (NSCLC). Furthermore, animal model experiments have indicated that the reduction of these molecules occurs before the establishment of cigarette smoking carcinogen-induced lung tumors, and this suggests roles in lung tumorigenesis. However, the functions of these molecules remain unknown in NSCLC.

Alveolar rhabdomyosarcoma of the anterior mediastinum with vessel invasion in a 4-month-old boy: a case report.

Introduction: Alveolar rhabdomyosarcomas of the mediastinum in children are rarely reported. Multimodality therapy including chemotherapy, surgery and radiotherapy make up the backbone of the treatment of childhood rhabdomyosarcomas. Complete resection whenever achievable is an important prognostic factor.

Estrogen receptor alpha promotes smoking-carcinogen-induced lung carcinogenesis via cytochrome P450 1B1.

Unlabelled: Smoking carcinogen N-nitrosamines such as 4-methylnitrosamino-l-3-pyridyl-butanone (NNK) require metabolic activation to exert their genotoxicity. The first activation step is mainly catalyzed by cytochrome P450 (CYP) family. Estrogen receptor α (ERα) plays a role in lung pathology.

Mediastinal follicular dendritic cell sarcoma with paraneoplastic pemphigus.

Follicular dendritic cell sarcoma is a rare neoplasm of immune accessory cells. It occurs primarily in lymph nodes. Occurrences in the mediastinum are rarely reported.

Hybrid Antegrade Thoracic Aortic Stenting via a Temporary Ascending Aortic Graft Conduit for a Patient with Poor Peripheral Vascular Access.

In patients with poor peripheral vascular access, thoracic aortic stenting procedures can be technically very challenging. Antegrade aortic stent deployments during concomitant open ascending and arch procedures are well described, but the issue of long endovascular catheters and wires may make such an approach difficult and awkward. We describe a novel hybrid method involving a temporary graft conduit to the ascending aorta which is brought caudal toward the foot of the table to facilitate antegrade deployment of the thoracic stent graft.

Cannula malposition during antegrade cerebral perfusion for aortic surgery: role of cerebral oximetry.

Purpose: To describe the use of cerebral oximetry to detect a lack of right cerebral perfusion resulting from a malpositioned catheter used for antegrade cerebral perfusion during deep hypothermic circulatory arrest (DHCA). The simple corrective surgical adjustment that followed averted a potentially serious complication.

Clinical Features: A 57-yr-old male with a type-A aortic dissection undergoing DHCA required antegrade cerebral perfusion for cerebral protection.

Delayed stent deformity and fracture of Djumbodis dissection system.

In recent years, a novel approach using the Djumbodis dissection system aortic stent has been introduced as an alternative to aortic arch replacement in acute type A aortic dissection involving the arch. From 2010 to 2013, we treated 7 patients with acute type A aortic dissection using the technique of replacing the ascending aorta with interposition graft and stenting of the aortic arch with the Djumbodis dissection system. We followed up the patients with serial imaging and in 3 consecutive patients who had been followed up for more than 10 months, we noted significant deformity and fracture of the Djumbodis stent.

Thromboxane A2 receptor α promotes tumor growth through an autoregulatory feedback pathway.

Tobacco smoking can cause a number of cancers. The role of thromboxane synthase (TxAS) in smoking-related cancers is largely unknown. In this study, 37 pairs of tumor and non-tumor lung tissues of non-small-cell lung cancer, 5 lung cancer cell lines, and a mouse tumor model were used to study TxAS and its related molecules.

Simple home-made suction device to aid excision of friable atrial myxoma.

Atrial myxoma, especially the papillary subtype, is known to be friable and gelatinous. Manipulation of an atrial myxoma during surgery can be very difficult, and not uncommonly results in fragmentation and embolization of part of the tumor. The conventional method using a metallic spoon to manipulate the tumor is widely practiced because alternatives are sparse.

Robotic thymectomy: The Hong Kong experience.

Thymectomy is widely employed as part of the management for generalized myasthenia gravis. The surgical approach has evolved over the years, and although there is no consensus regarding the optimal surgical approach, minimally invasive techniques such as video-assisted thoracoscopic thymectomy have gained popularity. Robotic-assisted surgical systems have been employed in recent years to perform thymectomies as the robotic arm allows extra wrist action of the instruments which provide seven degrees of movement, giving improved dexterity compared to the conventional thoracoscopic approach.

Solitary nasopharyngeal metastasis from lung primary: a long-term survivor after radiotherapy.

Isolated nasopharyngeal metastasis from lung primary is a rare condition. We report a patient with stage 1B adenocarcinoma of the lung who underwent anatomical lung resection and was subsequently found to have solitary nasopharyngeal metastasis. The patient received radiotherapy to nasopharynx and remained disease-free for 10 years from the date of diagnosis of nasopharyngeal metastasis.

Spontaneous haemopneumothorax: current management.

Spontaneous haemopneumothorax (SHP) can be life threatening and is an important cause for unexplained signs of significant hypovolaemia. There is still some debate relating to patient selection and timing of surgery, particularly in those who become stable following chest tube insertion without further blood loss. Review of the literature over the past decade in the management of SHP are presented and discussed.

Provision of stable lung isolation in an unstable patient: an endobronchial blocker through the Murphy eye of the in situ endotracheal tube.

Shortly after repair of a type A aortic dissection, resternotomy was required because of tamponade. During the exploration, it was discovered that the source of bleeding was in the right pleura. Collapse of the right lung was requested.

Mitral valve repair: past, present, and future.

Mitral valve repair is the operation of choice for mitral valve regurgitation, with appropriate selection. Studies have shown that mitral repair is associated with a decrease in both long-term thromboembolic complications and mortality. Since its initial description, various selection criteria and techniques of mitral valve repair have been discussed in the literature.

Recent advances in video-assisted thoracoscopic approach to posterior mediastinal tumours.

Minimal invasive video-assisted thoracic surgery can be a safe alternative technique in the assessment, diagnosis and surgical resection of posterior mediastinal tumours. Video-assisted thoracic surgery may be particularly suited for the management of posterior mediastinal tumours as most are benign. Surgical technique continues to evolve from the classic 3-port access in order to tackle more complex tumours positioned at the apical and inferior recesses of the posterior mediastinum.