Understanding the Role of Endothelial Cells in Glioblastoma: Mechanisms and Novel Treatments.

Glioblastoma is a highly aggressive neoplasm and the most common primary malignant brain tumor. Endothelial tissue plays a critical role in glioblastoma growth and progression, facilitating angiogenesis, cellular communication, and tumorigenesis. In this review, we present an up-to-date and comprehensive summary of the role of endothelial cells in glioblastomas, along with an overview of recent developments in glioblastoma therapies and tumor endothelial marker identification.

How I do it: repair of sternal fracture with bone graft and plating.

Described here is a technique of using bone graft and plating for fixation of traumatic sternal fractures with non-union. We recommend involvement of an orthopedic surgeon and consideration of bone graft use in sternal fractures where there is likely to be large gap between sternal edges.

Bilateral costal cartilage fractures sustained in the gym during repeated bench press exercises.

Costal cartilage fractures are common in high-energy blunt chest trauma but are frequently missed on imaging evaluation and accordingly underreported in the literature. In this report, we describe a case of a 32-year-old male who sustained bilateral costal cartilage fractures following repeated blunt trauma in the gym sustained during bench press exercises. The patient presented with a painful "clicking" of a rib in and out of place while bending or turning sideways.

Evaluation of the effects of three designs of oxygenators with integrated filters on clinical and haematological outcomes at an Australasian cardiothoracic unit.

Introduction: Cardiopulmonary bypass (CPB) machines have oxygenators with integrated filters and unique biocompatible coatings to combat systemic inflammatory response syndrome (SIRS) and mitigate coagulopathy. Contemporary oxygenators have undergone comparative studies; however, our study aimed to identify the most appropriate oxygenator for our regional Cardiothoracic unit in Australasia.

Methods: A prospective audit consecutively recruited one-hundred and fifty patients undergoing cardiac surgery at Waikato Hospital, New Zealand between the periods of 29th January 2018 and 31st July 2018.

Cardiac surgery simulation: a low-cost feasible option in an Australasian setting.

Background: Simulation training is a useful adjunct to surgical training and education (SET) in Cardiothoracic Surgery yet training opportunities outside the Royal Australasian College of Surgery or industry-sponsored workshops are rare due to high cost and limited training faculty, time, assessment tools or structured curricula. We describe our experience in establishing a low-cost cardiac simulation programme.

Methods: We created low-cost models using hospital facilities, hardware stores, abattoirs and donations from industry.

Performance of the AusSCORE II and STS Score for Coronary Artery Bypass Grafting in a New Zealand Population.

Background: The updated Australian System for Cardiac Operative Risk Evaluation (AusSCORE II) and the Society of Thoracic Surgeons (STS) Score are well-established tools in cardiac surgery for estimating operative mortality risk. No validation analysis of both risk models has been undertaken for a contemporary New Zealand population undergoing isolated coronary bypass surgery. We therefore aimed to assess the efficacy of these models in predicting mortality for New Zealand patients receiving isolated coronary artery bypass grafting (CABG).

Rate of Peritoneal Carcinomatosis in Resected Stage II and III Colon Cancer.

Introduction: Incidence of peritoneal carcinomatosis (PC) after curative resection of stage II and III colon cancer varies widely. Although certain features are considered high risk for PC, the impact of these features on PC incidence is unclear.

Methods: A retrospective analysis was performed on patients ≥ 18 years old with resected stage II and III colonic adenocarcinoma treated at two academic institutions from 2007 to 2018.

Early Discharge From Intensive Care After Cardiac Surgery is Feasible With an Adequate Fast Track, Stepdown Unit: Waikato Experience.

Background: Enhanced recovery programs within cardiothoracic surgery are a well described benefit to patient postoperative outcomes. We describe our Australasian unit's experience of a day zero discharge enhanced recovery unit from the intensive care department.

Methods: A retrospective study was conducted on a prospectively maintained database at Waikato Cardiothoracic Unit from September 2014 till October 2017 with 1,739 patients undergoing cardiac surgery.

Assessment of the EuroSCORE II in a New Zealand Tertiary Centre.

Background: The updated European System for Cardiac Operative Risk Evaluation (EuroSCORE II) is a well-established cardiac surgery risk scoring tool for estimating operative mortality. This risk stratification system was derived from a predominantly European patient cohort. No validation analysis of this risk model has been undertaken for the New Zealand population across all major cardiac surgery procedures.

Desmoid fibromatosis of the chest wall.

We report a case of desmoid fibromatosis of the chest wall. A 70-year-old woman was referred to our hospital with right shoulder blade pain and paresthesia over the right upper breast. Chest X-ray and computed tomography demonstrated a 5 cm right apical mass in the chest.

Impact of Insulin Degrading Enzyme and Neprilysin in Alzheimer's Disease Biology: Characterization of Putative Cognates for Therapeutic Applications.

Alzheimer's disease (AD) is a neurodegenerative process primarily characterized by amyloid-β (Aβ) agglomeration, neuroinflammation, and cognitive dysfunction. The prominent cause for dementia is the deposition of Aβ plaques and tau-neurofibrillary tangles that hamper the neuronal organization and function. Aβ pathology further affects numerous signaling cascades that disturb the neuronal homeostasis.

A rare case of cholesterol granuloma in the anterior mediastinum.

Cholesterol granulomas are reactant lesions that develop in response to cholesterol crystals and foreign body giant cells. They are a commonly described benign condition affecting the middle ear and paranasal sinuses, however have been reported in various sites within the body. We describe a rare case of an incidental cholesterol granuloma in the anterior mediastinum of a cardiac surgical patient.

Tricuspid valve repair for torrential tricuspid regurgitation after permanent pacemaker lead extraction.

Tricuspid regurgitation secondary to percutaneous lead extraction is uncommon, and it rarely requires surgical intervention. Most tricuspid regurgitation occurs during the implantation of tined leads, which can be entrapped in the tricuspid valve apparatus and may require immediate withdrawal. Severe tricuspid regurgitation as a sequela of extracting chronically implanted leads has rarely been reported.

Right atrial pacing for prevention of postoperative atrial fibrillation following coronary artery bypass grafting: a prospective observational trial.

Introduction: Atrial fibrillation (AF) is the most common complication after coronary artery bypass grafting (CABG). Conventional clinical practice is to treat AF after its onset in the postoperative period. However effective prophylaxis can result in reduced morbidity and hospital stay.

Ascending aortic tear with severe aortic regurgitation following rugby injury.

Blunt ascending aortic injuries are rare in clinical practice. Aortic valve regurgitation is an uncommon consequence of closed chest injury. It is caused by either ruptured valve cusp or when subadventitial rupture of the ascending aorta causes prolapse of subjacent valve cusp.

Optimal surgical management of descending necrotising mediastinitis: our experience and review of literature.

Introduction: Descending necrotising mediastinitis is a form of mediastinitis caused by odontogenic infection or deep cervical infections, which spreads to the mediastinum via the cervical fascial planes. Despite the increased use of CT scan as a diagnostic aid and the improvement in antibiotics, mortality in patients with descending necrotising mediastinitis remains high, reported between 25 and 40% in the literature. Surgical management and optimal form of mediastinal drainage remain controversial.

Idiopathic postpneumonectomy pulmonary edema: hyperinflation of the remaining lung is a potential etiologic factor, but the condition can be averted by balanced pleural drainage.

Objectives: Idiopathic postpneumonectomy pulmonary edema is a leading cause of mortality after pneumonectomy. Postoperative hyperinflation of the remaining lung is an etiologic factor. We have demonstrated avoidance of postpneumonectomy pulmonary edema solely by changing management of the pneumonectomy space to a balanced drainage system.