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). Eight animals from each group were euthanized on postoperative day 30 or 90. In vitro mucus transportability, in situ mucociliary transport, and ciliary beating frequency were measured.
Results: There was a significant impairment (p < 0.001) on ciliary beating frequency due to either bronchial transection or cyclosporine therapy. In vitro transportability was impaired only in cyclosporine-treated groups (p < 0.001). In situ mucociliary transport was reduced in cyclosporine-treated animals as well as in those that underwent bronchial transection (p < 0.001). This impairment was significantly recovered 90 days after operation. In contrast, the effects of cyclosporine did not change over 90 days of treatment.
Conclusions: These results support our hypothesis that mucociliary clearance is impaired after bronchial transection and cyclosporine therapy. Further studies are necessary to relate this finding with posttransplant infection and also to test some drugs aiming to protect airway mucociliary system.
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http://dx.doi.org/10.1016/j.athoracsur.2008.02.084 | DOI Listing |
Gen Thorac Cardiovasc Surg Cases
January 2025
Department of Surgery II, Faculty of Medicine, Yamagata University, Yamagata, Japan.
Background: With advancements in minimally invasive thoracic surgery techniques, such as video-assisted thoracoscopic surgery and robotic surgery, the design of vascular staplers has evolved to meet the requirements of these procedures. Consequently, newer generations of automatic staplers with improved handling and reduced size have been introduced, such as two-row staplers, which are more maneuverable and less bulky than their three-row counterparts.
Case Presentation: A 68-year-old man with lung cancer underwent a right middle and lower lobectomy due to tumor invasion into the central middle bronchial trunk, rendering the preservation of the middle lobe impossible.
Cureus
November 2024
First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, JPN.
Extralobar pulmonary sequestration (EPS) in the mediastinum is rare, and preoperative diagnosis can be challenging. We report a case of EPS in the middle mediastinum, where a congenital pericardial defect became apparent on computed tomography (CT) imaging as pneumopericardium concurrent with spontaneous pneumothorax. The patient presented with a left spontaneous pneumothorax.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg Cases
November 2023
Department of Thoracic Surgery, Okazaki City Hospital, City, Okazaki, Aichi, 444-8553, Japan.
Background: In bronchoplasty of wedge resections, it is necessary to transect the bronchus at a sharp angle and depth. As a result, anastomoses after wedge resections have the disadvantages of poor visibility and operability. Here, we report a case of right wedge-shaped sleeve bilobectomy that was successfully performed with continuous knotless suturing using robotic assistance.
View Article and Find Full Text PDFSurg Case Rep
August 2024
Department of Thoracic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-Machi, Kahoku-Gun, Ishikawa, 920-0293, Japan.
Background: Bronchial bifurcation abnormalities are often discovered incidentally on chest computed tomography or bronchoscopy. As this condition is asymptomatic, it has little effect on the disease course of patients with lung cancer. However, this abnormality must be considered when performing lung resection.
View Article and Find Full Text PDFJ Cardiothorac Surg
June 2024
Department of Cardiac Surgery, Children's Hospital Affiliated Shandong University, (Jinan Children?s Hospital), No. 23976, Jingshi Road, Huaiyin District, Jinan City, Shandong Province, China.
Background: Tracheobronchial injuries caused by blunt chest trauma are rare in children, and such injuries usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Herein, we describe the case of a 5-year-old patient who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus.
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