Pathogenetic role of eNOS uncoupling in cardiopulmonary disorders.

The homodimeric flavohemeprotein endothelial nitric oxide synthase (eNOS) oxidizes l-arginine to l-citrulline and nitric oxide (NO), which acutely vasodilates blood vessels and inhibits platelet aggregation. Chronically, eNOS has a major role in the regulation of blood pressure and prevention of atherosclerosis by decreasing leukocyte adhesion and smooth muscle proliferation. However, a disturbed vascular redox balance results in eNOS damage and uncoupling of oxygen activation from l-arginine conversion.

Prognostic factors and genetic markers in thymoma.

In this literature review prognostic factors and genetic markers that play a role in the staging of thymomas are discussed. The effect on prognosis of different factors, such as paraneoplastic syndromes, age, gender, classification, capsular invasion and surgical treatment, is evaluated. There is no generally accepted pathological classification of thymomas.

Lung ischemia-reperfusion injury: a molecular and clinical view on a complex pathophysiological process.

Lung ischemia-reperfusion injury remains one of the major complications after cardiac bypass surgery and lung transplantation. Due to its dual blood supply system and the availability of oxygen from alveolar ventilation, the pathogenetic mechanisms of ischemia-reperfusion injury in the lungs are more complicated than in other organs, where loss of blood flow automatically leads to hypoxia. In this review, an extensive overview is given of the molecular and cellular mechanisms that are involved in the pathogenesis of lung ischemia-reperfusion injury and the possible therapeutic strategies to reduce or prevent it.

Surgical resection of lung metastases including the role of locoregional therapy.

Although no randomized trials are available, surgical resection is a widely accepted treatment for selected patients with pulmonary metastases. Specific criteria have been well defined and a macroscopic complete resection should be obtained. Important prognostic factors include histology, number of metastases and disease-free interval.

Emergency endovascular aneurysm repair for ruptured abdominal aortic aneurysms: an institutional experience.

Objectives: Emergency endovascular aneurysm repair (eEVAR) for ruptured abdominal aortic aneurysms (rAAA) is still under investigation. Since installation of an urgent eEVAR kit in our hospital, all patients with a rAAA or urgent thoracic aortic aneurysm are candidates for eEVAR or eTEVAR (emergency thoracic EVAR), respectively. For this study, we analyzed all rAAA patients treated with eEVAR.

Filters placed in the superficial femoral arteries for limb salvage in a high-surgical-risk patient with atheroembolism: results at 2 years.

Purpose: To report the off-label use of Emboshield filters as a treatment for bilateral atheroembolism (trash foot) in an inoperable patient.

Case Report: A 64-year-old man with a juxtarenal abdominal aortic aneurysm (jAAA) presented with necrotic wounds of the forefoot and toes of both feet. Doppler imaging showed triphasic signals.

Trimodality therapy for malignant pleural mesothelioma: results from an EORTC phase II multicentre trial.

The European Organisation for Research and Treatment of Cancer (EORTC; protocol 08031) phase II trial investigated the feasibility of trimodality therapy consisting of induction chemotherapy followed by extrapleural pneumonectomy and post-operative radiotherapy in patients with malignant pleural mesothelioma (with a severity of cT3N1M0 or less). Induction chemotherapy consisted of three courses of cisplatin 75 mg·m⁻² and pemetrexed 500 mg·m⁻². Nonprogressing patients underwent extrapleural pneumonectomy followed by post-operative radiotherapy (54 Gy, 30 fractions).

Locoregional therapy.

Even after complete surgical resection of pulmonary metastases, many patients develop recurrent disease in the thorax despite the use of systemic chemotherapy, dosage of which is limited because of systemic toxicity. Although subsequent operations are feasible and good long-term results have been reported, sufficient functional lung parenchyma must remain. For this reason, new treatment strategies are explored.

Long-term survival of a phase I clinical trial of isolated lung perfusion with melphalan for resectable lung metastases.

Objective: Surgical resection of lung metastases is a widely accepted procedure but 5-year survival rates remain low and vary between 20% and 50%. Isolated lung perfusion (ILuP) is an experimental technique to deliver a high dose of chemotherapy to the lung, without systemic toxicity. Long-term survival of ILuP has not been reported yet and was determined in a phase I clinical trial.

Prognostic value of a biologic classification of non-small-cell lung cancer into the growth patterns along with other clinical, pathological and immunohistochemical factors.

Objectives: Classification of non-small-cell lung cancer (NSCLC) into growth patterns is based on the following question: What does the tumour do with normal lung parenchyma? There are only three possible ways according to which a tumour can behave: (1) preservation of lung tissue and use of its microenvironment for further growth, (2) destruction of lung tissue and formation of new microenvironment for continued expansion and (3) preservation of lung tissue and formation of new microenvironment (modulation). The aim of the current study is to test the prognostic value of growth-pattern classification along with other clinical, pathological and immunohistochemical factors.

Methods: Clinicopathological factors of 239 patients operated for NSCLC were retrospectively reviewed.

Quality of life after lung cancer surgery: a review.

The long-term goals of lung cancer surgery include cancer control, survival and quality of life (QoL). In a patient population with a high mortality rate, evaluation and preservation of QoL after treatment is imperative. Lung cancer patients already have a significant lower QoL compared to an age-matched healthy population with significant impairment in physical and emotional functioning.

Atypical presentation of an atypical carcinoid.

Carcinoids are malignant neuroendocrine tumors consisting of a spectrum of neoplasms from low-grade typical carcinoid to high-grade small cell carcinoma. Primary neuroendocrine lesions in the mediastinum, especially the thymic region, are rare. Therefore, presently no uniform criteria are available for diagnosis, staging, risk assessment, and treatment.

Intralobar bronchopulmonary sequestration with mixed venous drainage in a 10-year-old girl.

Bronchopulmonary sequestration consists of a mass of abnormal lung tissue that has no normal connection with the bronchial tree and is supplied with blood from an aberrant artery mostly originating in the thoracic aorta. Two forms are recognized: intralobar and extralobar sequestration. The first is localized within the normal visceral pleura and has a venous drainage into the pulmonary system; the latter is localized without the normal lung in its own pleura with venous drainage into the systemic venous system.

Different indications for repeat mediastinoscopy: single institution experience of 79 cases.

Aim: Different indications exist for repeat mediastinoscopy or remediastinoscopy (reMS). Presently, it is a valuable restaging tool in non-small cell lung cancer (NSCLC). Not only does it provide pathological evidence of mediastinal downstaging, it also selects those patients who will benefit from a subsequent surgical resection and determines prognosis.

An unusual case of traumatic pneumatocele in a nine-year-old girl: a bronchial tear with clear bronchial laceration.

Post-traumatic pneumatoceles (traumatic pulmonary pseudocysts) after blunt thoracic trauma are not frequently observed. It is widely accepted that pneumatoceles are caused by compression of the lung resulting in bursting parenchyma, followed by decompression of the chest with negative intrathoracic pressure. We present a case of post-traumatic pneumatocele in a nine-year-old girl who was crushed under the tailboard of a horse hamper.

Anatomical patterns of the above knee great saphenous vein and its tributaries: implications for endovenous treatment strategy.

Objective: The aim of the present study was to analyse the anatomical patterns of the above knee great saphenous vein (GSV) and its tributaries in limbs with varicose veins in view of potential suitability for endovenous treatment.

Methods: Limbs of a consecutive series of new patients with varicose veins presenting at the phlebologic clinic during a 4 month period were studied. In 73 limbs of 56 patients with varicose veins and both saphenofemoral junction and GSV reflux, anatomical patterns of the above knee GSV were defined as: --'complete' GSV: main trunk visualised within the saphenous compartment from the groin to the knee; --'incomplete' GSV: main trunk partially visualised from the groin to mid thigh with a non-refluxing mostly hypoplastic distal GSV and a superficial tributary vein (STV) parallel to the GSV.