Langerhans cell histiocytosis as differential diagnosis of a mediastinal tumor

We describe the case of a 55-year-old man who presented with parasternal swelling. The chest CT scan showed a large tumor of the chest wall infiltrating the subcutaneous tissue. To assume histologic diagnosis an open biopsy was performed. Between the myofibrils a coarse, white tumor with infiltrative growth was noted. Histopathologic examination revealed expanded atrophic skeletal muscle that was infiltrated by histiocytic cells. Numerous eosinophilic granulocytes and lymphocytes CD20 and CD3 positive could be detected and immunohistochemical staining was also positive for S-100 proteins and CD1a. Histologic findings were characteristic of Langerhans cell histiocytosis (LCH). To the best of our knowledge a LCH originating from the mediastinum in an adult as presented has not been previously describe

Delayed heart perforation after blunt trauma

A 33-year-old patient was hospitalized after a blunt chest trauma with a left flail chest. Six hours after admission to the intensive care unit the patient suddenly developed hypotension and tachycardia. His left chest tube drained 1.5 l of blood within minutes. Immediate resuscitation and emergency sternotomy with left anterolateral extension was performed for pericardial tamponade secondary to left ventricular perforation due to a sharp rib fragment. Outcome was favourable and the patient was operated on for his flail chest by internal stabilization the next da

Robotic lobectomy: tips, pitfalls and troubleshooting

The robotic approach in thoracic surgery has rapidly gained popularity in recent years. As with the introduction of any new technology, this warrants not only adaptation of the operative technique itself, but also the evolution of appropriate troubleshooting strategies. A selected number of helpful tips and technical procedural manoeuvres have been compiled to prevent intraoperative problems, as well as to overcome challenging situations that can arise during robotic lobectomies. In robotic surgery, as opposed to open surgery or video-assisted thoracic surgery, these tips serve an important purpose for the operating surgeon, as well as the entire surgical team involved in the procedure. All the assembled recommendations have proved their effectiveness and have been successfully used by the authors in many procedures. Furthermore, these manoeuvres have been found to be of great importance in the training and proctoring of thoracic surgeons, fellows and residents (bed-side assistants). This guide of clearly arranged tips and troubleshooting strategies offers surgeons a useful tool to overcome difficult situations in robotic lobectomy and preferably improve the reproducibility and safety of their procedure

Maximal sublattices and Frattini sublattices of bounded lattices

We investigate the number and size of the maximal sublattices of a finite lattice. For any positive integer k, there is a finite lattice L with more that ]L]k sublattices. On the other hand, there are arbitrary large finite lattices which contain a maximal sublattice with only 14 elements. It is shown that every bounded lattice is isomorphic to the Frattini sublattice (the intersection of all maximal sublattices) of a finite bounded lattic

Nanodroplet Flight Control in Electrohydrodynamic Redox 3D Printing

Electrohydrodynamic 3D printing is an additive manufacturing technique with enormous potential in plasmonics, microelectronics, and sensing applications, thanks to its broad materials palette, high voxel deposition rate, and compatibility with various substrates. However, the electric field used to deposit material is concentrated at the depositing structure resulting in the focusing of the charged droplets and geometry-dependent landing positions, which complicates the fabrication of complex 3D shapes. The low level of concordance between design and printout seriously impedes the development of electrohydrodynamic 3D printing and rationalizes the simplicity of the designs reported so far. In this work, we break the electric field centrosymmetry to study the resulting deviation in the flight trajectory of the droplets. Comparison of experimental outcomes with predictions of an FEM model provides new insights into the droplet characteristics and unveils how the product of droplet size and charge uniquely governs its kinematics. From these insights, we develop reliable predictions of the jet trajectory and allow the computation of optimized printing paths counterbalancing the electric field distortion, thereby enabling the fabrication of geometries with unprecedented complexity

sCR1sLeX reduces lung allograft ischemia-reperfusion injury but does not ameliorate acute rejection

Background: Combined inhibition of complement and leukocyte adhesion by sCR1sLeX reduces lung allograft dysfunction up to 24 h. In the present study its effect on graft function and acute rejection was evaluated up to 5 days after experimental transplantation. Methods: Orthotopic single left lung transplantation was performed in 35 male rats (Brown Norway to Fischer 344) after a total ischemic time of 20 h. Two groups were assessed after 1, 3, and 5 days post-transplant, respectively (n=5 per group and time point): controls vs. recipients which received 10 mg/kg sCR1sLeX 15 min prior to reperfusion. In addition, five animals received 10 mg/kg per day sCR1sLeX for 5 days. For blood gas analysis of the graft, the contralateral lung was occluded for 5 min to assess graft function. Lung grafts were flushed, and histological grading was performed in blinded fashion according to the International Society for Heart and Lung Transplantation criteria. Results: Graft PaO2 in recipients treated with sCR1sLeX was superior on day 1 (383±118 vs. 56±15 mmHg; P≪0.0001) and day 3 (446±48 vs. 231±108 mmHg; P≪0.0001). Five days after transplantation, no difference in PaO2 was found (61±28 vs. 83±31 mmHg; P=0.59). Repeated treatment with sCR1sLeX for 5 days did not improve PaO2 (64±5 mmHg; P=0.65 vs. control; P=0.93 vs. sCR1sLeX). At any time point, there was no difference in the degree of rejection between groups. Conclusions: In this model sCR1sLeX provided marked improvement of graft function up to 3 days, but inhibition of both complement system and selectin dependent leukocyte adhesion failed to protect against acute rejectio