Right Upper Lobe Torsion after Right Lower Lobectomy: A Rare and Potentially Life-Threatening Complication

An 84-year-old woman was referred to our institution with suspected right lung cancer. Subsequently, she underwent thoracoscopic right lower lobectomy without mediastinal lymph node dissection. Postoperatively, she complained of dyspnea and developed arterial oxygen desaturation after 12 h and acute respiratory failure (ARF). An emergency chest computed tomography revealed the right upper bronchial stenosis with hilar peribronchovascular soft tissue edema because the middle lung lobe had been pushed upward and forward and the right upper lung lobe had twisted dorsally. Emergency bronchoscopy revealed severe right upper bronchial stenosis with an eccentric rotation and severe edema. The bronchia stenosis was successfully treated with glucocorticoids and noninvasive positive pressure ventilation for ARF

Target-selective cytosolic delivery of cargo proteins using the VHH-presented OLE-ZIP capsules

In the pursuit of a new generation of protein pharmaceuticals, the efficient delivery of these therapeutics into cells stands out as a crucial challenge. In this study, we have developed a novel approach utilizing protein capsules modified with VHH antibodies as cytosolic carriers for protein pharmaceuticals. For the protein capsule component, we opted for the OLE-ZIP protein capsules, which can be prepared from the amphiphilic two-helix bundled protein OLE-ZIP using the water-in-oil (w/o) emulsion method. The spacious interior of the OLE-ZIP capsules allows for the stable encapsulation of over 200 molecules of protein pharmaceuticals, such as RNase A and Cre recombinase, in one capsule. By presenting the VHH antibody with an affinity for cell-type-specific receptors such as the epidermal growth factor receptor (EGFR) on the capsule surface, we achieved cell-type selective endocytic uptake in A431 cell lines (high expression level of EGFR) over NHDF and MCF-7 cells (normal expression level of EGFR). This selective uptake was followed by the subsequent release of the encapsulated protein pharmaceuticals into the cytosol of the target cells. Unlike our previous version of the OLE-ZIP protein capsules modified with IgG antibodies, cytosolic delivery of pharmaceutical proteins was little impacted by the presence of other IgGs, which are abundant in the bloodstream. This improved characteristic suggests potential advantages for practical applications, including intravenous administration

Covered Stent of the Left Common Carotid and Subclavian Arteries Assist the Invasive Tumor Resection

Background. Some recent reports have described the usefulness of thoracic aortic stent grafts to facilitate en bloc resection of tumors invading the aortic wall. We report on malignant peripheral nerve sheath tumor resection in the left superior mediastinum of a 16-year-old man with neurofibromatosis type 1. The pathological margin was positive at the time of the first tumor resection, and radiation therapy was added to the same site. After that, a local recurrence occurred. The tumor was in wide contact with the left common carotid and subclavian arteries and was suspected of infiltration. After stent graft placement of these arteries to avoid fatal bleeding and cerebral ischemia by clamping these arteries and bypass procedure, we successfully resected the tumor without any complications. Conclusions. Here, we report the usefulness of the prior covered stent placement to aortic branch vessels for the resection of invasive tumor

Comparative study of local versus general anesthesia in video-assisted thoracoscopic surgery for empyema

Objective: This study evaluated the feasibility of performing non-intubated video-assisted thoracoscopic surgery (VATS) with local anesthesia for parapneumonic effusion and empyema resistant to conservative treatment. Methods: We retrospectively reviewed 80 patients who underwent surgery for parapneumonic effusions and empyema between 2015 and 2021. Patients were divided into those who received non-intubated local anesthesia and general anesthesia during surgery. Patient demographics, characteristics, laboratory findings, treatment progress, and treatment outcomes were compared. The primary outcomes were duration of postoperative drainage, postoperative complication rate, and postoperative mortality rate within 30 days. Results: Among patients who received local (n = 21) and general anesthesia (n = 59), there was a significant difference in age (median 79.0 years [interquartile range (IQR) 77.0–80.0] vs. 68.0 years [IQR 54.5–77.5]; p < 0.001), preoperative performance status (3.0 [IQR 2.0–4.0] vs. 2.0 [IQR 1.0–3.0]; p < 0.001), and operative time (69 min [IQR 50–128] vs. 150 min [IQR 107–198]; p < 0.001) but not in preoperative white blood cell count (12,100/μL [IQR 8,400–18000] vs. 12,220/μL [IQR 8,950–16,724]; p = 0.840), C-reactive protein (15.2 mg/dL [8.8–21.3] vs. 17.9 mg/dL [IQR 9.5–23.6]; p = 0.623), postoperative drainage period (11 days [IQR 7–14] vs. 9 days [7–13]; p = 0.216), postoperative hospital stay (22 days [IQR 16–53] vs. 18 days [IQR 12–26]; p = 0.094), reoperation rate (9.5% vs. 15.3%; p = 0.775), postoperative complication rate (19.0% vs. 18.6%; p = 0.132), or postoperative 30-day mortality rate (4.8% vs. 0%; p = 0.587). Conclusions: VATS using local anesthesia is feasible for patients with treatment-resistant parapneumonic effusion and empyema with poor general condition

A Corpus-Centered Approach to Spoken Language Translation

This paper reports the latest performance of components and features of a project named Corpus- Centered Computation (cS), which targets a trans- lation technology suitable for spoken language translation. C s places corpora at the center of the technology. Translation knowledge is extracted from corpora by both EBMT and SMT methods, translation quality is gauged by re)brring to corpora, the best translation among multiple-engine outputs is selected based on corpora and the corpora themselves are paraphrased or filtered by automated processes