Recurrent hemoptysis with Penicillium marneffei and Stenotrophomonas maltophilia in Job's syndrome.

Pulmonary infection caused by the opportunistic organisms Penicillium marneffei and Stenotrophomonas maltophilia in patients with Job's syndrome is rare and not well documented. The case of a 30-year-old man with Job's syndrome who developed recurrent pneumonia and lung abscesses caused by P. marneffei and S.

Multidisciplinary management of life-threatening massive hemoptysis: a 10-year experience.

Background: Life-threatening massive hemoptysis requires prompt action and thoracic surgical input. Although there are a number of reports regarding each therapeutic modality for medical or surgical treatment, the significance of a multidisciplinary strategy remains undetermined.

Methods: From January 1995 to December 2005, 120 patients were referred to our cardiothoracic center with massive hemoptysis.

Increased inducible nitric oxide synthase in lung carcinoma of smokers.

Background: Cigarette smoking is well known to play an important role in the development of lung cancer. Inducible nitric oxide synthase (iNOS) can either promote or inhibit cell proliferation and growth, which makes its role in the development of malignant tumors controversial. The relation between cigarette smoking and iNOS in human lung cancer is unknown.

Surgical treatment for empyema thoracis: is video-assisted thoracic surgery "better" than thoracotomy?

Background: Operations for empyema thoracis are conventionally performed by open thoracotomy, whereas the video-assisted thoracic surgery (VATS) approach remains controversial. This study compares the radiologic and functional outcomes of decortication using the two approaches.

Methods: During a 5-year period, 77 consecutive patients underwent decortication for empyema thoracis at two university teaching hospitals.

Video-assisted thoracic surgery for pneumothorax in LAM.

Spontaneous pneumothorax is one of the more common presentations of lymphangioleiomyomatosis; however, recurrences are common which can be challenging to manage particularly in bilateral pneumothorax. We present a case of recurrent bilateral spontaneous pneumothorax associated with lymphangioleiomyomatosis, diagnosed intra-operatively, and confirmed by the resected lung specimen. Video-assisted thoracic surgery bullectomy and mechanical as well as talc pleurodesis was required to prevent further recurrences.

Video-assisted thoracic surgery lobectomy for lung cancer is associated with less immunochemokine disturbances than thoracotomy.

Objective: Major surgery is immunosuppressive and could have an impact on postoperative tumor immunosurveillance and recurrence in cancer patients. Low circulating levels of insulin growth factor binding protein (IGFBP)-3 have been linked to advance prostate and the development of colonic cancers. This prospective study examined the early postoperative circulating levels of IGFBP-3, matrix metalloproteinase (MMP)-9, and tissue inhibitor of metalloproteinase (TIMP)-1 in early stage non-small cell lung cancer (NSCLC) patients undergoing major lung resection by VATS versus thoracotomy.

Video-assisted thoracic surgery for early stage lung cancer - can short-term immunological advantages improve long-term survival?

The development of video-assisted thoracic surgery (VATS) in the past decade has changed the way many pulmonary conditions are being treated. VATS has gained popularity among clinicians due to faster recovery following surgery, less postoperative pain and better cosmesis. It is well known that surgical trauma can induce a systemic inflammatory response and affect postoperative systemic immunity.

Pre-emptive local anesthesia for needlescopic video-assisted thoracic surgery: a randomized controlled trial.

Objective: Studies in other surgical specialties have suggested that pre-emptive wound infiltration using a local anesthetic may reduce post-operative pain. We report the first randomized trial to assess the use of pre-emptive local anesthesia in video-assisted thoracic surgery (VATS).

Method: Thirty-one consecutive patients undergoing bilateral needlescopic VATS sympathectomy for palmar hyperhidrosis were studied prospectively.

Bronchiolitis obliterans following lung transplantation.

Bronchiolitis obliterans syndrome (BOS) is the main and late chronic complication after lung transplantation. It remains a major impediment to long-term outcome. Unfortunately, the survival rate of lung transplant recipients lags behind that of other organ transplant recipients, and BOS accounts for more than 30% of all mortality after the third year following lung transplantation.

Bronchoscopic management of airway obstruction in pediatric endobronchial tuberculosis.

The present report describes a case of severe airway obstruction caused by endobronchial tuberculosis in an 11-year-old girl who was successfully treated by bronchoscopic balloon dilation. This case illustrates the insidious presentation and the increasingly important role of bronchoscopic intervention in the management of endobronchial tuberculosis. In addition, a brief literature review of the condition in the pediatric age group is included.

Analgesic effect of electroacupuncture in postthoracotomy pain: a prospective randomized trial.

Background: The role of electroacupuncture in postthoracotomy pain control is uncertain. We conducted a pilot study to evaluate the role of electroacupuncture in the management of early postthoracotomy wound pain.

Methods: A total of 27 patients with operable non-small cell lung carcinoma who received thoracotomy were recruited and randomized to receive either electroacupuncture or sham acupuncture in addition to routine oral analgesics and patient-controlled intravenous analgesia for postoperative pain control.

Video-assisted thoracic surgery pulmonary resection for lung cancer in patients with poor lung function.

Background: The aim of this study is to evaluate the early outcome of patients with poor lung function who underwent video-assisted thoracic surgery (VATS) pulmonary resection for primary non-small cell lung carcinoma.

Methods: We reviewed retrospectively the records of patients with lung cancer undergoing VATS lung resection over a period of 5 years. Twenty-five patients with preoperative poor lung function defined as forced expiratory volume in 1 second less than 0.

The use of gabapentin for post-operative and post-traumatic pain in thoracic surgery patients.

Objective: The pain following thoracic surgery and trauma is often refractory to conventional analgesic strategies. However, it shares key characteristics with neuropathic pain which gabapentin, an anticonvulsant, has been proven to effectively treat. To our knowledge, this is the first prospective study assessing the use of gabapentin in cardiothoracic surgery patients.

Video-assisted thoracic surgery thymectomy for nonthymomatous myasthenia gravis.

Study Objectives: Minimal-access thymectomy has become increasingly popular as surgical treatment for patients with nonthymomatous myasthenia gravis (NTMG) because of its comparable efficacy, safety, and lesser degree of tissue trauma compared with conventional open surgery. We reviewed and analyzed our data on video-assisted thoracic surgery (VATS) thymectomy and present the clinical outcomes according to the Myasthenia Gravis Foundation of America classification.

Design: A retrospective review of VATS thymectomy for NTMG in a university hospital over a 12-year period.

Thoracotomy is associated with significantly more profound suppression in lymphocytes and natural killer cells than video-assisted thoracic surgery following major lung resections for cancer.

Major surgery is immunosuppressive, and this could have an impact on postoperative tumor immunosurveillance and, therefore, long-term survival in cancer patients. Video-assisted thoracic surgery (VATS) lung resection is a new alternative surgical approach to thoracotomy for patients with early lung cancer. This is a pilot study to examine the postoperative changes in leukocytes, lymphocyte subsets, B cells, T cells, and natural killer (NK) cells in non-small-cell lung cancer (NSCLC) patients undergoing lung resection with VATS versus thoracotomy approaches.

Post-pneumonectomy empyema: current management strategies.

Post-pneumonectomy empyema is an uncommon but potentially life-threatening complication. It has a strong association with bronchopleural fistula, which acts as a continued source of infection into the thoracic cavity. Numerous risk factors have been identified and strategies formulated to minimize its occurrence.

Alveolar capillary dysplasia with congenital misalignment of pulmonary vessels.

Alveolar capillary dysplasia with misalignment of pulmonary vessels is an uncommon congenital cause of persistent pulmonary hypertension of the newborn. It is universally fatal, and diagnosis is entirely dependent upon surgical lung biopsy. We present a case of alveolar capillary dysplasia with misalignment of pulmonary vessels occurring in a full-term neonate, emphasizing that early involvement of the thoracic surgeon for a histological diagnosis allows expensive and ineffective treatments to be avoided.

Incidence of chest wall paresthesia after needlescopic video-assisted thoracic surgery for palmar hyperhidrosis.

Objective: Chest wall paresthesia is a reported sequela of thoracotomy and Video-Assisted Thoracic Surgery (VATS) which is distinct from wound pain. Although needlescopic VATS confers less post-operative pain and better cosmesis, the incidence of paresthesia after needlescopic VATS has not been quantified.

Methods: For homogeneity of the patient cohort, we studied 50 patients who received bilateral needlescopic VATS sympathectomy (T2-T4 excision) for palmar hyperhidrosis using 2 or 3 mm instruments during a 36-month period at a single institute.

Video-assisted thoracic surgery for primary spontaneous hemopneumothorax.

Objective: Video-assisted thoracic surgery (VATS) has changed the way we manage a number of thoracic conditions. This study presents near over a decade of experience from our institution on management of spontaneous hemopneumothorax (SHP), with particular reference to the use of VATS.

Methods: Retrospective review between March 1988 and December 2002 with 793 patients treated for spontaneous pneumothorax, 30 (3.

Spectral karyotyping indicates complex rearrangements in lung adenocarcinoma of nonsmokers.

Adenocarcinoma (AdC) of the lung represents a common histologic subtype of non-small cell lung cancer. While there is a rising incidence of AdC in nonsmoking women, information on the cytogenetic changes involved has been minimal to date. In the present study, spectral karyotyping analysis uncovered the genome-wide chromosomal aberrations in two AdC tumors derived from women who were lifelong nonsmokers.

Early results of endoscopic lung volume reduction for emphysema.

Background: We determined the feasibility, safety, and short-term efficacy of bronchoscopic placement of a one-way endobronchial valve in selected bronchopulmonary segments as an alternative to surgical lung volume reduction.

Methods: A total of 21 patients with incapacitating emphysema who underwent this procedure were studied. All patients had placement of the endobronchial valves into the most emphysematous lung segments.

Should cervical ultrasonography be a routine staging investigation for lung cancer patients with impalpable cervical lymph nodes?

Objectives: Detection of cervical N3 lymph nodes is currently not a routine preoperative investigation for lung cancer patients. We designed a study to assess if the frequency and accuracy of detection of metastatic cervical lymph nodes using cervical ultrasonography (US) and fine needle aspiration (FNA) justify their routine use in all lung cancer patients with impalpable cervical lymph nodes.

Methods: Fifty patients with suspected and potentially operable non-small cell lung cancer were enrolled.