Tracheal malignant melanoma: successful outcome with tracheal resection.

Primary tracheal malignant melanomas are uncommon neoplasms: only five cases have been reported. Different therapeutic approaches are described, with a short life expectancy observed. We report a case of a young woman with a primary tracheal malignant melanoma who underwent complete tracheal resection and is free of disease 4 years after surgical treatment.

Effects of cyclosporine A and bronchial transection on mucociliary transport in rats.

Background: Posttransplant infection remains the leading cause of morbidity and mortality after lung transplantation. We hypothesized that bronchial transection and immunosuppression by cyclosporine both play a key role in the impairment of airway mucociliary clearance, a basic defense system.

Methods: Sixty-four rats were assigned to four groups of 16 each according to surgical procedure and drug therapy as follows: sham-operated and saline solution; bronchial transection and saline solution; sham-operated and cyclosporine; bronchial transection and cyclosporine (10 mg/kg/day).

Bilateral lung transplantation in asymmetric thorax: case reports.

Suppurative lung diseases, such as cystic fibrosis and bronchiectasis, when diffuse and associated with important functional loss, can be treated with bilateral lung transplantation with good results. These diseases are frequently associated with previous lung resections presenting an asymmetric thorax, thus making lung extraction difficult and generating disproportion between the graft and the pleural cavity. To treat this condition, pneumonectomy and single lung transplantation is a feasible option; however, there are associated comorbidities and an invariable need for extracorporeal circulation.

Bacterial and fungal pneumonias after lung transplantation.

Objective: The aim of this study was to evaluate the epidemiology of bacterial and fungal pneumonia in lung transplant (LT) recipients and to assess donor-to-host transmission of these microorganisms.

Materials And Methods: We retrospectively studied all positive cultures from bronchoalveolar lavage (BAL) of 49 lung transplant recipients and their donors from August 2003 to April 2007.

Results: There were 108 episodes of pneumonia during a medium follow-up of 412 days (range, 1-1328 days).

The quality of life of patients on the lung transplantation waiting list.

Introduction: Lung transplantation (LTx) candidates present incapacitating symptoms related to their mobility and activities of daily living, thereby affecting their work, social and emotional relations, and quality of life (QoL).

Objective: To study the QoL of LTx candidates, seeking to identify domains that suffer the greatest impact and verify if there are differences among these impairments according to the original lung disease.

Methods: We applied the Short Form-36 questionnaires and St George's Respiratory Questionnaire (SGRQ).

Idiopathic tracheal stenosis: successful outcome with antigastroesophageal reflux disease therapy.

There is controversial evidence that gastroesophageal reflux disease (GERD) is an etiologic factor for idiopathic laryngotracheal stenosis. We present the case of a 44-year-old woman with symptomatic tracheal stenosis managed as idiopathic stenosis. She underwent six endoscopic dilations during 1 year, and before surgery she underwent 24-hour esophageal pH monitoring that documented GERD.

The role of videopericardioscopy in evaluating indeterminate pericardial effusions.

Background: The pericardial biopsy has opened a new perspective for the etiologic diagnosis of pericardial effusions, because adequate pericardial visualization via the use of a video camera can provide more accurate results. We assessed the usefulness of videopericardioscopy for the diagnosis and treatment of pericardial effusion of indeterminate origin.

Methods: We conducted a retrospective study of clinical data from patients who underwent videopericardioscopy examination for pericardial effusion without an established diagnosis.

Influence of cyclosporine A on mucociliary system after lung transplantation in rats.

Purpose: To investigate the function of the bronchial mucociliary system in transplanted rat lungs with and without the influence of immunosuppression.

Methods: Thirty-six rats underwent single-lung transplantation and were divided into two groups, one of which received cyclosporine treatment, and the control group which did not. Cyclosporine was administered subcutaneously in doses of 10 mg/kg daily.

Cyclosporin A reduces airway mucus secretion and mucociliary clearance in rats.

Purpose: To assay the effects of cyclosporin A on mucus secretion from goblet cells and on mucociliary transport in situ in rats.

Methods: Twenty-one male Wistar rats were assigned to 3 groups: control (n = 5), saline (n = 8), and cyclosporin A (n = 8). After 30 days of drug therapy, the rats were killed, and the lungs were removed from the thoracic cavity.

Myocardial revascularization in a patient with situs inversus totalis.

We report the case of a patient with dextrocardia and situs inversus totalis associated with obstructive coronariopathy in the anterior and posterior descending arteries, right coronary artery, first diagonal branch and left marginal branch. The patient underwent coronary artery bypass grafting surgery. This surgery has been rarely reported in literature and we found only one similar case in the national medical literature.

Left ventricular lipoma.

We report the case of a 21-year-old female referred to our institution complaining of dizziness when standing up, which improved in the dorsal decubitus position and at rest, after a few minutes. The symptom, which had lasted for years, was not accompanied by vertigo, syncope, or neurological changes, but was gradually getting worse. Transthoracic echocardiogram showed a hyperechoic mass in the middle-apical region of the left ventricular posterior wall and normal pericardium.

Ligation of the thoracic duct for the treatment of chylothorax in heart diseases.

In children, chylothorax occurs mainly after cardiac and thoracic surgeries. One of the recommended postsurgery treatments is ligation of the thoracic tract, when all other conservative treatments have failed. We report 4 cases of chylothorax in patients who were successfully treated with this approach, which resulted in a decrease in pleural drainage without recurrent chylothorax.

Right atrial lipoma.

Benign cardiac tumors are rare, and lipomas are among those less frequently found. We report the case of a 48-year-old male complaining of high blood pressure and epistaxis in the last 2 months, with a diagnosis of right atrial lipoma established on echocardiography, magnetic resonance imaging, and anatomicopathological examination. The tumor was successfully removed, and up to 42 months after surgical excision, no evidence of tumor relapse was observed.

Thymectomy by partial sternotomy for the treatment of myasthenia gravis.

Background: Myasthenia gravis is an autoimmune disease characterized by weakness and fatigue of voluntary muscles. Surgical treatment of choice for myasthenia gravis has been thymectomy. However, thymectomy indications and surgical approach are still controversial.

Video-assisted pericardioscopy. How to improve diagnostic efficacy in pericardial effusions.

Objective: To assess, in a prospective way, the experience with video-assisted pericardioscopy obtained in patients with pericardial effusion of unclear etiology in the preoperative period.

Methods: From January 1998 to June 2000, 20 patients were operated upon with the aid of video-assisted pericardioscopy. On echocardiography, 17 of these patients had significant pericardial effusion, and 3 had moderate pericardial effusion.

Ischemic preconditioning in myocardial revascularization with intermittent aortic cross-clamping.

Background: This study tests the hypothesis that initial brief periods of ischemia can increase the protection obtained by intermittent aortic cross-clamping.

Methods: In the control group (n = 18), the procedure was performed under intermittent aortic cross-clamping at 32 degrees C. Patients in the preconditioned gorup (n = 17) received a stimulus of two 3-minute periods of cross-clamping followed by 2 minutes of reperfusion prior to standard operation.

Cholesterol pericarditis. A specific but rare cause of pericardial disease.

During a diagnostic investigation in a 40-year-old male with pericardial effusion associated with hypothyroidism, cholesterol pericarditis was detected. We report a brief review on the etiopathogeny, clinical findings, and therapeutical possibilities of this entity.

Chylothorax after myocardial revascularization with the left internal thoracic artery.

A 38-year-old male underwent coronary artery bypass grafting (CABG). A saphenous vein graft was attached to the left marginal branch. The left internal thoracic artery was anastomosed to the left anterior descending artery (LAD).

Angiographic evaluation of graft patency in minimally invasive direct coronary artery bypass grafting.

Background: The objective of this report is to describe our experience using minimally invasive direct coronary artery bypass grafting and to evaluate angiographic patency of anastomoses.

Methods: A total of 120 patients (86 men) were operated on, with ages ranging from 30 to 83 years (mean = 61.2 years).

Influence of biopump with and without intraaortic balloon on the coronary and carotid flow.

Background: The objective of this study was to evaluate the influence of biopump used for left ventricular assistance on the coronary and carotid flows in dogs with normal heart. The efficacy of the simultaneous use of an intraaortic balloon pump to compensate the possible deleterious effects of the circulatory assistance with continuous flow was also analyzed.

Methods: Fifteen dogs were studied.

Self-expanding endovascular stent-graft implant for treatment of descending aortic diseases.

Background: Aneurysms and dissections involving the descending thoracic aorta and the distal portion of the aortic arch are difficult to resolve surgically. The introduction of endovascular self-expanding stent-grafts has simplified the operation. Given the complications associated with their peripheral placement, we explored the feasibility of surgical insertion.

Management of aortic dissection that involves the right coronary artery.

A report on the follow-up of 11 patients who suffered from aortic dissection involving the right coronary artery and who underwent surgical treatment is reported. In two patients, the left coronary ostia was also affected. In seven patients, the dissection was acute and in four, chronic.