Intraoperative HFJV support during bronchoplasty

High frequency jet ventilation (HFTV) was experimentally studied to ensure intraoperative respiratory support at tracheo-bronchoplasty. On the condition of driving pressure of 5 to 15 PSI and frequency of 100 to 400 during bronch-plastic procedure, HFJV is of great help to shorter the operation time and to secure the anastomosis. And the arterial Po2 and Pco2, and pulmonary hemodynamics were kept satisfactory in the circumstances of intraoperative respiratory suppor

Oxidative stress induction of DJ-1 protein in reactive astrocytes scavenges free radicals and reduces cell injury

Astrocytes, one of the predominant types of glial cells, function as both supportive and metabolic cells for the brain. Under cerebral ischemia/reperfusion-induced oxidative conditions, astrocytes accumulate and activate in the ischemic region. DJ-1 has recently been shown to be a sensor of oxidative stress in living cells. However, the function of astrocytic DJ-1 is still unknown. In the present study, to clarify the effect of astrocytic DJ-1 protein under massive oxidative insult, we used a focal ischemic rat model that had been subjected to middle cerebral artery occlusion (MCAO) and reperfusion. We then investigated changes in the distribution of DJ-1 in astrocytes, DJ-1 release from cultured astrocytes, and the effects of recombinant DJ-1 protein on hydrogen peroxide (H2O2)-induced death in normal and DJ-1-knockdown SH-SY5Y cells and on in vitro scavenging of hydroxyl radicals (•OH) by electron spin resonance spectrometry. At 24 h after 2-h MCAO and reperfusion, an infarct lesion was markedly observed using magnetic resonance imaging and 2,3,5-triphenyltetrazolium chloride staining. In addition, reactive astrocytes enhanced DJ-1 expression in the penumbral zone of the ischemic core and that DJ-1 protein was extracellularly released from astrocytes by H2O2 in in vitro primary cultures. Although DJ-1-knockdown SH-SY5Y cells were markedly vulnerable to oxidative stress, treatment with glutathione S-transferase-tagged recombinant human DJ-1 protein (GST-DJ-1) significantly inhibited H2O2-induced cell death. In addition, GST-DJ-1 protein directly scavenged •OH. These results suggest that oxidative stress induces the release of astrocytic DJ-1 protein, which may contribute to astrocyte-mediated neuroprotection

Recurring radiation-induced angiosarcoma of the breast that was treated with paclitaxel chemotherapy: a case report

Background Angiosarcoma of the breast is very rare and can be divided into primary and secondary angiosarcoma. Radiation-induced angiosarcoma (RIAS) is classified as secondary angiosarcoma. Diagnosis of RIAS is difficult due to its rarity, and the interpretation of pathological imaging is complicated. In the National Comprehensive Care Network (NCCN) guidelines, the first choice of treatment is surgery with negative margins. Adjuvant radiotherapy (RT) for close soft tissue margins should be considered. Preoperative or adjuvant chemotherapy of nonmetastatic disease is not recommended for angiosarcoma. We report a case of RIAS, which was impossible to diagnose with core needle biopsy (CNB) but was diagnosed by excisional biopsy. The patient was then administered adjuvant chemotherapy using conjugated paclitaxel (PTX). Case presentation A 62-year-old woman noticed a tumor in her right breast. She had a history of right breast cancer and had undergone breast-conserving surgery, RT, and tamoxifen therapy 8 years previously. CNB, which was performed twice, was inconclusive. The tumor was surgically excised and pathological analysis yielded a diagnosis of angiosarcoma. She then underwent a right mastectomy. One month after she underwent right mastectomy, a nodule reappeared on the skin of her right breast, and excisional biopsy revealed recurrence of angiosarcoma. A few weeks later another nodule reappeared near the post-operative scar and excisional biopsy revealed recurrence of angiosarcoma. We assumed that surgical therapy was insufficient because the patient experienced relapse of angiosarcoma after complete mastectomy. After the second recurrence, we treated her with systemic chemotherapy using PTX. There was no evidence of recurrence 8 months after chemotherapy. Conclusion Although angiosarcoma is difficult to diagnose, many patients have a poor prognosis. Therefore, prompt treatment intervention is desired. Moreover, there is little evidence regarding adjuvant therapy of angiosarcoma since it is a rare disease. We consider that adjuvant therapy helped to effectively prevent recurrence in the patient after complete excision

Benefit from omentopexy on bronchial wound healing in performing concurrent esophagectomy

The healing process of bronchial wound was compared among wrapping tissues such as pedicled omentum, pericardium, and parietal pleura in terms of the degrees of revascularization of the bronchial artery interrupted by bronchoplasty itself by microangiography, including the circumstances of performing a procedure of esophagectomy. The development of neovascularity was marked and facilitated by omentopexy. The procedure of wrapping by pedicled pericardium and pleura was not so useful for promoting neovascularity as would be expected, and it was almost the same as non-wrapping one. Meanwhile, recanalization by wrapping with free pleura was delayed. When esophagectomy was combined with bronchoplasty, revascularization was apparently retarded. In conclusion, wound healing at bronchial anastomosis was markedly impaired so that omentopexy was recommended for facilitating wound healing at anastomosis

Cytoprotective roles of GSH, SOD and solcoseryl against ischemic damage and reperfusion injury to warm ischemic lung. Study of Canine warm ischemic lung.

This study was performed to clarify the roles of reduced glutathion (GSH), superoxide dismutase (SOD), and solcosaryl in ischemic damage and reperfusion injury to the warm ischemic lungs of experimental animals. Fifty-one warm ischemic canine lungs were made by hilar stripping and clamping of the left PA, PV and bronchus for 2-3 hours. In the Non-perfusion group, GSH (50mg/ kg, I. V.: Group II) and solcoseryl (50mg/kg, I. V.: Group III) were administered. In the perfusion group, Euro-Collins (E-C) solution (20ml/kg) was perfused (Group IV) and GSH (1mg/ml in E-C solution: Group V) and SOD (15mg/l in E-C solution : Group VI) were used for anti-oxidative drugs. The pulmonary arterial pressure and aortic pressure were measured and also blood gas analysis was made during the preischemic period , immediately after, one hour and 3 days after reperfusion. Small parts of pulmonary tissues were taken for pathological examination one hour and 3 days after reperfusion. Chest X-ray films were teken at 3 days after the operation. GSH, SOD, and solcoseryl effectively act as scavengers of active oxygen species (AOS) , especially in terms of oxygenation. In the group with anti-oxidative drugs, cytoprotective effects of the pathological and chest X-ray findings on ischemic damage and reperfusion injury were much more manifest rather than those in control groups

Surgery for myasthenia gravis

The effect of thymectomy on myasthenia gravis was evaluated in the 48 patients with thymectomy for myasthenia gravis in the First Department of Surgery, Nagasaki University School of Medicine. The surgical approaches were done by midsternotomy in 44, by right thoractomy in 3 and by transcervical route in 1 respectively. As a rule, extended thymectomy was mainly applied. The disease stages in most cases included the types of Osserman II b and/or II a. The effect of thymectomy on myasthenia gravis was compared between the patients with and without thymoma. The effect of thymectomy for patients without thymoma was superior to that for patients with thymoma. There was no close relationship between the suffering time and the effect of thymectomy. Interestingly enough, the surgical outcome for those who had moderate or severe formation of germinal center in the resected thymic glands was not satisfactory and some aggravated following thymectomy

Effecs of cyclosporine on bronchial anastomotic healing in canine lung allograf t

Wound healing at bronchial anastomosis of the lung allograft in canine was compared between allografts prescribed with cyclosporine and/or azathioprine and autografts in terms of recanalization of bronchial artery, breaking strength and histologic findings. 1) Restoration of interrupted bronchial artery completed at the 14 day following transplantation in autografts and allografts with cyclosporine, although it has been retarded until day 21 when azathioparine was given. 2) Satisfactory breaking strength at anastomosis was equally measured in autografts and allografts with cyclosporine. In allografts with azathioprine, weakened breaking strength was noticed on day 14 with significant difference (p<0.05). 3) From the standpoint of histologic finding, cyclosporine is of benefit to eliminate inflammatory response and to promote collagen production which was essential to good wound healing

Histological evaluation of cancer extension along the bronchial wall in lung cancer.

The surgical specimens obtained from 39 cases in which primary lung cancers were situated in the central portion proximal to subsegmental bronchi were histologically examined as to how long cancer lesions extend along the bronchial wall, based on grossly visible lesions in the mucosa. Of 34 cases, 87% showed proximal cancer extension along the bronchial wall. The mode of cancer spread was mainly adventitioal extension and the distence was within 20mm of the sites of grossly visible lesions in the mucosa. In cases with involvement of the mediastinal lymph nodes and/or carcinoma of undifferentiated histological type, there was a tendency to spread widely. When cancer was located in the orifice of the lobar bronchus, the peripheral cancer spreading was obvious. Based on these results, it is concluded that the site of resection of the bronchus should be 20mm distant from macroscopically recognizable cancer changes in the mucosa. In most cases (71.4%), however the extent of invasion in the bronchial wall was less than 10mm from such changes

Oxidative Neurodegeneration Is Prevented by UCP0045037, an Allosteric Modulator for the Reduced Form of DJ-1, a Wild-Type of Familial Parkinson’s Disease-Linked PARK7

Although a loss-of-function mutation has been identified in familial Parkinson’s disease PARK7, the wild-type of DJ-1 is known to act as an oxidative stress sensor in neuronal cells. Recently, we identified UCP0045037 as a compound that bound to the reduced form of DJ-1 by in silico virtual screening. In this study, we determined the neuroprotective effects of UCP0045037 against focal cerebral ischemia-induced neurodegeneration in rats. Hydrogen peroxide-induced cell death was significantly inhibited by UCP0045037 in both rat mesencephalic dopaminergic neurons and human normal SH-SY5Y cells. In contrast, DJ-1-knockdown SH-SY5Y cells lost the protective activity of UCP0045037. These results suggest that UCP0045037 interacts with endogenous DJ-1 and produces a neuroprotective response