The incidence and risk factors of acute pain after preoperative needle localization of pulmonary nodules: a cross-sectional study

Background: The incidence, severity and associated risk factors of acute pain after preoperative needle localization of pulmonary nodules are poorly characterized. We therefore conducted a cross-sectional study to quantify the acute pain induced by preoperative needle localization of small pulmonary nodules before video-assisted thoracoscopic surgery (VATS). Methods: We conducted this study at Shanghai Chest Hospital from September 2021 through December 2021. Eligible patients were between 18 and 75 years old and had small pulmonary nodules requiring preoperative CT-guided needle localization. The intensity of acute pain was assessed using the visual analogue scale (VAS) after preoperative needle localization. A VAS score ≥4 cm indicated moderate to severe pain. Patient demographics and CT-guided localization factors were collected to identify significant predictors associated with moderate to severe pain. Results: A total of 300 patients were included in the final analysis, with a mean (SD) age of 51 (SD =12) years old; 63% were female. Moderate to severe pain occurred in 50.8% of patients during deep breathing and 45.7% of patients during movement. Multivariate logistic regression analysis showed that multiple localization needles [multiple needle localizations vs. single needle localization, odds ratio (OR): 2.363, 95% confidence interval (CI): 1.157–4.825, P=0.018] and the specific location of needle puncture on the chest wall were significant predictors of moderate to severe pain after CT-guided needle localization (lateral chest wall vs. anterior chest wall OR: 2.235, 95% CI: 1.106–4.518, P=0.025; posterior chest wall vs. anterior chest wall OR: 1.198, 95% CI: 0.611–2.349, P=0.599). Conclusions: In adult patients receiving hookwire CT-guided localization, moderate to severe pain was common. Avoiding the localization route through lateral chest wall may be helpful and pharmacological medications or regional blockade is necessitated in high-risk population

Management of lung nodules newly found by virtual-assisted lung mapping: a case report

Abstract Background Virtual-assisted lung mapping is a novel bronchoscopic lung marking technique that uses virtual images to perform multiple concurrent dye marking of barely palpable pulmonary tumors. Subsequent chest computed tomography is required to confirm the locations marked. We here report a patient in whom computed tomography after virtual-assisted lung mapping unexpectedly revealed additional tiny pulmonary nodules. Case presentation A 64-year-old woman with a history of renal cell carcinoma presented with two pulmonary nodules suspicious of metastases from renal cell carcinoma. Because we anticipated that the nodules would be difficult to palpate intraoperatively, we performed virtual-assisted lung mapping prior to attempting to resect them. Computed tomography after mapping unexpectedly detected two additional nodules. Although the existing markings did not relate to the newly found nodules, we used imaginary auxiliary lines and anatomical landmarks to extend the lung map to incorporate the unexpected nodules. The additional nodules were successfully resected by thoracoscopic wedge resection. Pathologic examination identified all nodules as metastases from renal cell carcinoma, and the surgical margins were negative. Conclusions Imaginary auxiliary lines and anatomical landmarks extended the existing lung map of virtual-assisted lung mapping, enabling resection of unexpected pulmonary nodules found in post-mapping computed tomography images

Comparison of characteristics of mouse immortalized normal endothelial cells, MS1 and primary cultured endothelial cells.

Tumor blood vessels support the progression of tumors by providing nutrition and oxygen required for growth. By acting as gatekeepers, they allow the metastasis of tumors to secondary locations. An important strategy in cancer therapy has been to target tumor blood vessels consequently inhibiting tumor angiogenesis. To date, antiangiogenic therapy being employed for cancer treatment have yielded profoundly good results. However, it has been shown that current antiangiogenic drugs have several problems, such as adverse side effects and drug resistance. Tumor endothelial cells (TEC), which line the inner layer of blood vessels of the tumor stromal tissue, are the main targets of the antiangiogenic therapies. TEC have been reported to differ significantly from endothelial cells resident in normal blood vessels. These differences provide a window through which TEC can be targeted solely with little or no impact on normal endothelial cells (NEC). Currently, as part of new antiangiogenic drug discovery processes, cell-based screening is being performed using thousands of small chemical compounds. For the success of such screening purposes, there is a need to obtain the right kind of cells and in adequate quantities. Primary–cultured endothelial cells isolated from murine / human blood vessels are the preferred choice. However, maintenance of the primary-cultured endothelial cells is costly and overtime these cells become senescent and perish. As a result, MS1, SV40 immortalized islet-derived endothelial cells, have been used in place of the primary-cultured cells. MS1 is commercially available with comparatively cheaper cell culture requirements. 　In this study, we compared the characteristics of MS1 and primary-cultured endothelial cells ; NEC and TEC to investigate the possibility of using MS1 cells for chemical screening in search of a new antiangiogenic drug. MS1 cells proliferate faster compared to TEC and upregulated the mRNA expressions of CD133 and Sca-1 genes. However, mRNA expression of most of the other genes, which were upregulated in TEC compared to NEC, were also expressed at lower levels in the MS1 cells. Furthermore, MS1 migrated at a slower rate and did not form tubes on matrigel, as opposed to the function of TEC. In conclusion, MS1 did not completely resemble NEC, nor TEC in function and gene expression. It is suggested that for chemical screening, primary-cultured TEC and the corresponding NEC would be a more ideal choice of cells

Good's syndrome with clinical manifestation after thymectomy: A case report

Good's syndrome is a rare condition of immunodeficiency that is characterized by thymoma and hypogammaglobulinemia. A 74-year-old Japanese woman underwent total thymothymectomy for type AB thymoma (2015 WHO classification). She developed recurrent infectious diseases caused by Escherichia coli (bacteremia), Streptococcus pneumoniae (pneumonia and bacteremia) and Pseudomonas aeruginosa (bacteremia) in the year after thymectomy. The serum levels of immunoglobulin were significantly low (IgG 157mg/dL), which suggested that her infectious diseases were associated with Good's syndrome. Although she began receiving intravenous immunoglobulin every four weeks, she died of pneumonia a week after the second administration of immunoglobulin. When physicians encounter patients with recurrent infection who have a medical history of thymoma, the detection of hypogammaglubulinemia can be a key clue to the diagnosis of Good's syndrome. Keywords: Good's syndrome, Thymoma, Immunodeficiency, Hypogammaglobulinemi

Determination of Plasmid pSN1216-29 Host Range and the Similarity in Oligonucleotide Composition Between Plasmid and Host Chromosomes

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Oxygen concentration affects frequency and range of transconjugants for the incompatibility (Inc) P-1 and P-7 plasmids pBP136 and pCAR1

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Raman microspectroscopy for label-free diagnosis of amyloid light-chain amyloidosis in various organs

Systemic amyloidosis is a group of diseases in which misfolded proteins aggregate as fibrous amyloid proteins with a β-sheet structure and deposit in organs, resulting in organ failure. Most types of amyloidosis have a poor prognosis, and prompt diagnosis is essential for treatment. Amyloid light-chain (AL) amyloidosis is a type of systemic amyloidosis that occurs when abnormal immunoglobulin light chain proteins are deposited in various organs and tissues. The deposition of amyloid proteins in tissues has traditionally been confirmed using Congo red staining and polarised light microscopy, which show apple-green birefringence. In this study, we aimed to verify whether amyloid deposition in the heart, kidney, rectum, duodenum, and skin can be detected using Raman microspectroscopy. Serial sections were prepared from formalin-fixed paraffin-embedded tissue biopsy samples obtained from patients with systemic amyloidosis. One of the serial sections was stained with Congo red to confirm the deposition of amyloid proteins using polarised light microscopy, whereas the other was left unstained for Raman microspectroscopy. A characteristic peak at Raman shift of 1665-1680 cm-1, which may represent a β-sheet structure of amyloid proteins, was recorded in the area where the amyloid deposition had been confirmed by Congo red staining. Based on the peak at 1640–1680 cm-1, a colour map was obtained to detect amyloid protein-positive regions. Thus, amyloid protein detection using Raman microspectroscopy may be useful for rapid diagnosis of amyloidosis