Bronchial and arterial sleeve resection for centrally-located lung cancers

The use of bronchial and arterial sleeve resections for the treatment of centrally-located lung cancers, when available, has become the option of choice in comparison with pneumonectomy (PN). Technical expertise, in particular in vascular reconstruction, and perioperative management improved over time allowing excellent short-term and long-term results. This is even truer if considering literature data from the main experiences published in the last years. These evidences have given to such lung sparing reconstructive procedures more and more acceptance among the surgical community. This article focuses on the main technical aspects and literature data regarding bronchovascular sleeve resections

Evaluating Alpha and Beta Taxonomy in Ant-Nest Beetles (Coleoptera, Carabidae, Paussini)

We evaluated completeness, accuracy, and historical trend of the taxonomic knowledge on the myrmecophilous ground beetle tribe Paussini (Coleoptera, Carabidae, Paussinae). Accumulation curves for valid names and synonyms of species, subgenera, and genera were modelled using logistic functions. Analyses of trends in synonymies suggest that few currently accepted taxa will be recognized to be synonymous in the future. This may indicate that Paussini are a taxonomically relatively stable tribe of carabid beetles. However, this result might also be due to the lack of recent taxonomic work in some biogeographical regions

Long term compensatory sweating results after sympathectomy for palmar and axillary hyperhidrosis

Endoscopic thoracic sympathectomy is currently the best treatment for primary upper extremity hyperhidrosis, but the potential for adverse effects, particularly the development of compensatory sweating, is a concern and often precludes surgery as a definitive therapy. This study aims to evaluate long-term results of two-stage unilateral versus one-stage bilateral thoracoscopic sympathectomy

A Novel Technique for Laryngotracheal Reconstruction for Idiopathic Subglottic Stenosis

Idiopathic subglottic stenosis is the most challenging condition in the field of upper airway reconstruction. We describe a successful novel technique for enlarging the airway space at the site of the laryngotracheal anastomosis in very high-level reconstructions

Salvage resection of advanced mediastinal tumors

The surgical treatment of locally advanced mediastinal tumors invading the great vessels and other nearby structures still represent a tricky question, principally due to the technical complexity of the resective phase, the contingent need to carry out viable vascular reconstructions and, therefore, the proper management of pathophysiologic issues. Published large-number series providing oncologic outcomes of patients who have undergone extended radical surgery for invasive mediastinal masses are just a few. Furthermore, the wide variety of different histologies included in some of these studies, as well as the heterogeneity of chemo and radiation therapies employed, did not allow for the development of clear oncologic guidelines. Usually in the past, surgical resections of large masses along with the neighbouring structures were not offered to patients because of related morbidity and mortality and limited information available on the prognostic advantage for long term. However, in the last decades, advances in surgical technique and perioperative management, as well as increased oncologic experience in this field, have allowed radical exeresis in selected patients with invasive tumors requiring resections extended to the surrounding structures and complex vascular reconstructions. Such aggressive surgical treatment has been proposed in association or not with adjuvant chemo- or radiotherapy regimens, achieving encouraging oncologic results with limited morbidity and mortality in experienced institutions. Congestive heart failure or impending cardiovascular collapse due to the compression by the large mass are the most frequent immediately lifethreatening problems that some of these patients can experience. In this setting, medical palliation is usually ineffective and an aggressive salvage surgical treatment may remain the only therapeutic option

the long awaited first instar larva of paussus favieri coleoptera carabidae paussini

Paussus favieri Fairmaire is one of only two species of the myrmecophilous carabid tribe Paussini known from Europe. Larvae are known from only 10 of the 580 paussine species. As in many beetles with considerably modified later instar larvae, the first instars represent a valuable source of informative characters for taxonomy and phylogenetic analyses (primary chaetotaxy, egg-bursters, etc.). Therefore, the discovery of the first instar larva of P. favieri is particularly important, as it represents only the second species for which this larval stage is known. In this paper we describe the behavior and morphology of the larval first instar of P. favieri (subtribe Paussina of Paussini) and compare it with that of Arthropterus sp. (subtribe Cerapterina), which is the only other 1st instar described in the Paussini. Most surprisingly, we found that the 1st instar of P. favieri lacks a prostheca, which was previously thought to be a synapomorphy of Paussina + Platyrhopalina. Rather, P. favieri has a unique mandibular structure that seems to be functionally analogous to the protheca. It is a long, broadly lanceolate, distinctly flattened structure apparently homologous to the medial mandibular seta (MN2*), which arises from an area behind the cutting edge of mandible. We predict that the function of the protheca and this similar structure in P. favieri are involved in a specialized feeding strategy that may include soliciting trophallaxis from their host ants. We also report some observations of the first instar hatching from the egg, feeding on liquid and a behaviour we interpret as a "calling behavior," all of which were videotaped and posted on the Tree of Life Web Project

form function and evolutionary significance of stridulatory organs in ant nest beetles coleoptera carabidae paussini

Stridulatory organs in the myrmecophilous carabid beetle tribe Paussini have long been recognized and used as a defining character of some genera and higher level taxa, however their morphology has only roughly been described. Here, we describe the fine morphology of Paussini stridulatory organs using scanning electron (SeM) and focused ion beam (FIB) microscopy. Within this tribe, there are three types of stridulatory organs, each with different positions of the scraper (plectrum) and file (pars stridens). type I (abdomen-femur type) is located on the abdomen (scraper) and metafemur (file) in the subtribe Paussina (sensu Geiselhardt et al., 2007, Naturwissenschaften 94: 871-894). type II (thorax-femur type) and ype III (femur-thorax type) are located on the mesothorax and mesofemur in two different genera of the subtribe Platyrhopalina, however in Euplatyrhopalus the scraper is located on the mesothorax and the file is located on the mesofemur (t ype II), whereas in the genus Platyrhopalopsis the structures are reversed in that the file is located on the mesothorax and the scaper is located on the mesofemur (t ype III). the independent evolution of three types of stridula ­ tory organs in three lineages of Paussini suggests that acoustical communication has played an important role in the evolution of ant nest beetles. While the roles of stridulation in this group remain speculative, we verified that all three types of stridulatory organs are present in both sexes and are similar to stridulatory organs known in their host ants which also use stridulation as a method of com­ munication. We discuss the possibility that the beetles' stridulation could (1) facilitate their exploitation of ant colonies, and (2) be involved in mate recognition and courtship

Reconstruction of the heart and the aorta for radical resection of lung cancer

Introduction: We report a single-center experience of resection and reconstruction of the heart and aorta infiltrated by lung cancer in order to prove that involvement of these structures is no longer a condition precluding surgery. Methods: Twenty-seven patients underwent surgery for lung cancer presenting full-thickness infiltration of the heart (n = 6) or the aorta (n = 18) and/or the supra-aortic branches (subclavian n = 3). Cardiac reconstruction was performed in 6 patients (5 atrium, 1 ventricle), with (n = 4) or without (n = 2) cardiopulmonary bypass, using a patch prosthesis (n = 4) or with deep clamping and direct suture (n = 2). Aortic or supra-aortic trunk reconstruction (n = 21) was performed using a heart-beating crossclamping technique in 14 cases (8 patch, 4 conduit, 2 direct suture), or without crossclamping by placing an endovascular prosthesis before resection in 7 (4 patch, 3 omental flap reconstruction). Neoadjuvant chemotherapy was administered in 13 patients, adjuvant therapy in 24. Results: All resections were complete (R0). Nodal staging of lung cancer was N0 in 14 cases, N1 in 10, N2 in 3. No intraoperative mortality occurred. Major complication rate was 14.8%. Thirty-day and 90-day mortality rate was 3.7%. Median follow-up duration was 22 months. Recurrence rate is 35.4% (9/26: 3 loco-regional, 6 distant). Overall 3- and 5-year survival is 60.9% and 40.6%, respectively. Conclusions: Cardiac and aortic resection and reconstruction for full-thickness infiltration by lung cancer can be performed safely with or without cardiopulmonary bypass and may allow long-term survival of adequately selected patients

Surgical treatment of lung cancer with adjacent lobe invasion in relation to fissure integrity

Background Tumor with adjacent lobe invasion (T‐ALI) is an uncommon condition. Controversy still exists regarding the optimal resection of adjacent lobe invasion, and the prognostic value in relation to fissure integrity at the tumor invasion point. The aims of this paper were to evaluate the prognosis of T‐ALI with regard to fissure integrity, and type of resection. Methods This was a retrospective multicenter study which included all consecutive patients with T‐ALI undergoing surgical treatment. Based on radiological, intraoperative and histological findings, T‐ALI patients were differentiated into two groups based on whether the fissure was complete (T‐ALI‐A group) or incomplete (T‐ALI‐D Group) at the level of tumor invasion point. Clinico‐pathological features and survival of two study groups were analyzed and compared. Results Study population included 135 patients, of these 98 (72%) were included into T‐ALI‐A group, and 37 (38%) into T‐ALI‐D Group. T‐ALI‐D patients had better overall survival than T‐ALI‐A patients (63.9 ± 7.0 vs. 48.9 ± 3.9; respectively, P = 0.01) who presented with a higher incidence of lymph node involvement (35% vs. 4%; P = 0.004), and recurrence rate (43% vs. 16%; P = 0.01). At multivariable analysis, T‐ALI‐D (P = 0.01), pN0 stage (P = 0.0002), and pT≤5 cm (P = 0.0001) were favorable survival prognostic factors. Conclusions T‐ALI‐D presented a better prognosis than T‐ALI‐A while extent of resection had no effect on survival. Thus, in patients with small T‐ALI‐D and without lymph node involvement, sublobar resection of adjacent lobe rather than lobectomy could be indicated. Key points The extent of resection of adjacent lobe had no effect on survival while T‐ALI‐D, pN0 stage, and pT≤5 cm were significant prognostic factors. In patients with small T‐ALI‐D and without lymph node involvement, sublobar resection of adjacent lobe could be indicated as an alternative to lobectomy