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Intrathoracic ectopic kidney is an extremely rare congenital defect that is frequently identified by accident because it is asymptomatic. Even more unusual is its link to pulmonary sequestration alone. This case report describes the clinical presentation of a 7-month-old child with a history of recurrent respiratory distress and chest infections since birth, who had shortness of breath, failure to thrive, and delayed developmental milestones. The clinical examination and imaging revealed an ectopic right kidney in the thoracic cavity, as well as a probable sequestered lung lobe. Thoracotomy revealed a healthy right lung with a collapsed lower lobe connected to the ectopic kidney. The right lower third lobe was released to be in its normal appearance and the sequestration vessels were ligated. The patient recovered smoothly after surgery, with the exception of a brief episode of pneumonia that was treated. The patients follow up confirmed complete recovery without complications. [ABSTRACT FROM AUTHOR]

This study was conducted to produce a three-dimensional model of the thorax and lower respiratory tract in Van cats, to reveal their morphometric properties, and to investigate the anatomical structure of this region in more detail. A total of 16 adult Van cats (8 males and 8 females) were used in the study. The thoracic region of the cats was scanned using multidetector computed tomography device. The images of the scanned region were transferred to the MIMICS 20.1 software that creates three-dimensional reconstruction in order to produce the models. The morphometric measurements were obtained from these models and the index values were calculated. When the data were analysed in terms of sexual dimorphism, significant differences were determined between the sexes in terms of transverse diameter of the thoracic cavity in apertura thoracis cranialis (T2) (P < 0.05), minimum width of apertura thoracis cranialis (T3), and height of the thoracic cavity in thoracis cranialis (H1) (P < 0.01). The index values of the data revealed a significant difference between the sexes only in terms of the thoracic index 2 (P < 0.05). The 7th sternebra was shorter and more flattened than the other sternebrae in Van cats. In conclusion, three-dimensional models of the thorax and lower respiratory tracts of Van cats were produced in the study. It is thought that the data of the study may be useful in clinical practice and academic studies in the field of veterinary medicine. [ABSTRACT FROM AUTHOR]

The Neotropical otter (Lontra longicaudis) is a mustelid distributed geographically from Mexico to Argentina. Anomalous origins of the aortic arch branches are rarely reported in wild carnivorans. Therefore, this study aimed to report the anomalous branching of the aortic arch in one formaldehyde‐fixed specimen of L. longicaudis. The aortic arch provided three branches: the bicarotid trunk and the left and right subclavian arteries. The latter passed dorsally to the esophagus toward the right side without a mark of compression at the esophagus. This is the first report of an anomalous origin of the right subclavian artery in L. longicaudis. [ABSTRACT FROM AUTHOR]

A 37-year-old male, with a 5-year history of liposarcoma of the right thigh, was incidentally diagnosed with two huge thoracic metastases following a fall. One of these masses, measuring 22 cm, was located in the right chest apex, adjacent to a second 20 cm mass situated in the anterior mediastinum, partially invading the left chest. The patient underwent surgical intervention for mass resection that commenced with a hemi-clamshell incision, but was then extended by completing the lower median sternotomy in order to create a T shaped incision. This type of incision provides ample access for large mediastinal tumors that extensively extend into one side of the thoracic cavity, encompass the anterior mediastinum, and partially reach into the opposite cavity. It enhances visualization, facilitates access to vital organs, allows for precise surgical maneuvers, minimizes the risk of inadvertent tissue damage, and enables thorough oncological resection. [ABSTRACT FROM AUTHOR]

Ectopic pancreatic tissue can occasionally cause inflammation, hemorrhage, stenosis, and invagination, similar to normal pancreatic tissue; however, tumorigenesis is rare. This case report describes an ectopically observed pancreatic acinar cell carcinoma in the thoracic cavity of a female Fischer (F344/DuCrlCrlj) rat. Histopathologically, polygonal tumor cells with periodic acid-Schiffpositive cytoplasmic eosinophilic granules showed solid proliferation and infrequently formed acinus-like structures. Immunohistochemically, the tumor cells were positive for cytokeratin, trypsin, and human B-cell leukemia/lymphoma 10, which specifically reacted with pancreatic acinar cells, and negative for vimentin and human a-smooth muscle actin. Ectopic pancreas develops in the submucosa of the gastrointestinal tract; however, there are few reports of its development and neoplasia in the thoracic cavity. To the best of our knowledge, this is the first report of ectopic pancreatic acinar cell carcinoma in the thoracic cavity of a rat. [ABSTRACT FROM AUTHOR]

Pericardial cysts (PCs) are uncommon benign congenital anomalies residing in the middle mediastinum. The location of PCs is diverse with 70% of cases in the right cardiophrenic angle, 22% in the left cardiophrenic angle, and 8% in the posterior (as in our case) or superior anterior part of the mediastinum. In 2019, a 54-year-old woman was referred to the emergency department of Imam Khomeini Hospital Complex (Tehran, Iran) suffering from progressive shortness of breath. The chest computed tomography scan showed an unusual giant cystic lesion occupying >50% of the right hemithorax. The cystic lesion was primarily located in the posterior mediastinum. The patient underwent video-assisted thoracoscopic surgery (VATS), and the cyst was completely resected from the mediastinum. During past decades, several cases of PCs have been reported in different age and sex groups. Here, we present a case of a giant pericardial cyst (PC) located in the posterior mediastinum. The cyst was successfully resected using VATS. Only one other study has reported a PC in the posterior mediastinum. [ABSTRACT FROM AUTHOR]

Mediastinal masses have been eluding clinicians for a long time, owing to their common symptoms that are attributable to common infective and non infective etiologies and their rare incidence. They are generally diagnosed in the anterior mediastinum and include a variety of different entities demonstrating a range of clinicopathologic features. Chest computed tomography is important for the diagnosis, to know the extent of disease and helps in the prognosis. The prognosis of mature teratoma is excellent, surgical removal is curative. This case report was of a 58-year-old female, an unusual age of presentation, diagnosed as benign mature teratoma and was managed conservatively with periodic assessment for symptomatology. A conservative rather than surgical approach was chosen keeping in mind the socio-economic profile of the patient, surgical complications, and benign nature of the disease. The uniqueness of our case is hidden behind the unusual presentation of the disease coupled with belonging to an eastern world where surgical modalities are not as accessible and affordable. Hence, a conservative approach might be an equally effective solution, especially considering the age of presentation. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate chest mobility though cirtometry and sit-and-reach testing (SRT) in children and adolescents with cystic fibrosis (CF) before and after 3 months of the implementation of an institutional exercise booklet and to verify the correlation between the tests and the espirometry. Material and methods: Experimental study with patients between 8 and 18 years of age with CF colonized by Pseudomonas aeruginosa. The measurement of thoracic mobility was performed through cirtometry and SRT before and after three months of performing home exercises in the form of stretches, guided through an institutional exercise booklet. Espirometry variables, such as forced expiratory volume of the first second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio, were obtained from the medical records. Shapiro-Wilk test was used to verify the normality of the variables, Spearman method to correlate the espirometry variables with the initial assessment of the thoracic mobility and Wilcoxon method to verify the difference between the tests before and after the exercises. A p less than 0,05 was considered statistically significant. Results: 10 patients were evaluated in the first phase of the study, 80% female, with a mean age of 14,9 years. The initial SRT reached 44,1±10,17cm, whereas the difference in initial cirtometry measurements between inspiration and expiration was 3,3±1,06cm in axillary region, 3,5±1,3cm in xiphoid region and 3,7±1,1cm in umbilical region. There was a strong correlation between the values obtained in the tests and espirometry values. After home exercise, both cirtometry and SRT improved significantly (p<0,0001). Conclusion: Home exercises were effective in the improvement of the thoracic mobility, reflecting the importance of guidelines and the incentive to adherence to treatment in children and adolescents with CF. [ABSTRACT FROM AUTHOR]

Background: Matrix metalloproteases (MMPs) are multi-chain proteins that regulated by tissue inhibitor of metalloproteinases (TIMP) and several other mechanisms. This Includes transcription regulation and protein form secretion. The roles of MMPs in wound healing and tissue repair. In tuberculosis (TB), the activity of MMPs is increased and TIMP inhibitors decrease activity. Therefore, in tuberculosis, MMPs cause excessive damage to the lung tissue and cavity formation. Methods: In a case-control study, plasma samples of healthy controls, symptomatic respiratory tract controls and tuberculosis patients were evaluated by available sampling in Ali Ibn Abitaleb and Bouali Hospitals, Zahedan, Iran, from Apri1 2015 to April 2018. Patients were divided into two groups: tuberculosis and control group and the level of MMPs were measured by the enzyme-linked immunosorbent assay (ELISA) method in plasma samples of the two groups. For MMP-8, which was important in the diagnosis of tuberculosis, a cutoff point was obtained. Results: 384 people including 123 healthy controls. 107 non-tuberculosis, and 154 tuberculosis patients were examined; 230 patients in the control group and 154 patients in the tuberculosis group. Levels of MMPs in tuberculosis and symptomatic respiratory group were higher than healthy group. The mean of MMP-8 was significantly different between two groups (P<0.001). In this study, sensitivity, specificity, positive and negative predictive value of plasma MMP-8 in detection of TB in non-TB patients in MMP-8 cutoff point=6650 pg/ml were 65.4%, 78.2%, 50%, and 93% respectively outcome. Significantly, the rate of pulmonary cavity was significantly higher in the TB group; Higher cavity, higher concentration of plasma MMPs. Conclusion: In this study, first comprehensive analysis of MMPs was performed. Two collagenases, MMP-1 and MMP-8, were active in tuberculosis, but MMP-8 was specifically higher in tuberculosis than in both symptomatic and healthy controls. Level of MMP-1, 3, 8, 9 was higher in men than in women. The analysis of genders separately showed MMP-8 was increased in tuberculosis group in comparison with control group and MMP-1 group in both TB and symptomatic respiratory tract increased. [ABSTRACT FROM AUTHOR]

Introduction: thoracic neurogenic tumors are relatively uncommon neoplasms that arise from glial cells, ganglia, paraganglia, or peripheral nerve. They account for 90% of all posterior mediastinal masses and 12-21% of all primary mediastinal tumors. Nerve sheath tumors usually appear as well-circumscribed, slowgrowing tumors. Cellular schwannomas account for up to 5% of benign nerve sheath tumors in adults. They are asymptomatic in more than half of cases and are usually incidentally discovered through routine radiographic examinations. Large mediastinal cystic masses can cause difficulty in breathing and even superior vena cava syndrome. Aim: to demonstrate our experience with symptomatic thoracic cystic schwannoma, surgical treatment and follow-up of the patient. Case report: we present a case of a previously healthy 63-year-old female patient with symptomatic thoracic cystic schwannoma, which was successfully treated with surgery at our Clinic, with complete resolution of the patient's symptoms. [ABSTRACT FROM AUTHOR]

Malignant peripheral nerve sheath tumor (MPNST) is a rare variety as sporadic tumor but more common when associated with neurofibromatosis, and its usual site of origin lies in the extremities. MPNST of thoracic cavity is a rare site of origin with only anecdotal reports in literature. Progression to a large size without distant metastases is even rarer owing to its high metastatic potential. We present a case of thoracic MPNST highlighting its rarity and the treatment options available to provide a best possible outcome. [ABSTRACT FROM AUTHOR]

Approximately 100 million people suffer from filarial diseases including lymphatic filariasis (elephantiasis), onchocerciasis (river blindness) and loiasis. These diseases are amongst the most devastating of the neglected tropical diseases in terms of social and economic impact. Moreover, many infection-induced immune mechanisms in the host, their relationship to disease-related symptoms and the development of pathology within the site of infection remain unclear. To improve on current drug therapies or vaccines, further studies are necessary to decipher the mechanisms behind filaria-driven immune responses and pathology development, and thus the rodent model of Litomosoides sigmodontis can be used to unravel host-filaria interactions. Interestingly, BALB/c mice develop a patent state (release of microfilariae, the transmission life-stage, into the periphery) when exposed to L. sigmodontis . Thus, using this model, we determined levels of host inflammation and pathology development during a L. sigmodontis infection in vivo for the first known time. Our study reveals that after 30 days p.i., inflammation and pathology began to develop in infected wild type BALB/c mice between the lung and diaphragm, close to the site of infection – the thoracic cavity. Interestingly, infected IL-4Rα/IL-5 −/− BALB/c mice had accentuated inflammation of the pleural lung and pleural diaphragm, and higher parasite burdens. Corresponding to the pleural inflammation, levels of IP-10, MIP-1α, MIP-1β, MIP-2 and RANTES were significantly elevated in the thoracic cavity fluid of infected IL-4Rα/IL-5 −/− mice compared with wild type controls. Moreover, upon L. sigmodontis antigen stimulation, IFN-γ and IL-17A secretions by cells isolated from draining lymph nodes of IL-4Rα/IL-5 −/− mice were significantly elevated, whereas secretion of IL-5, IL-13 and IL-10 was reduced. Elevated filaria-specific IFN-γ secretion was also observed in spleen-derived CD4 + T cell co-cultures from IL-4Rα/IL-5 −/− mice. In summary, this study unravels the essential role of IL-4/IL-5 signalling in controlling immunity against filarial infections and demonstrates the requirement of this pathway for the host to control ensuing pathology and inflammation. [ABSTRACT FROM AUTHOR]

The present study is performed on a number of 4 bodies of nutria. At this species, the azygos vein is placed on the right side, opening in cranial vena cava at the third intercostal space level, after intersecting from top to bottom the right side of the trachea and esophagus. At coypu, the vagal nerve is in direct contact with dorsolateral edge of the trachea. The parietal and visceral lymph nodes of the thoracic cavity were studied using the China 40% ink dye colouring method. The method used for highlight the lymph nodes was the stratigraphic and regional dissection, up to the limit of the visibility, and subsequently using the Nikon stereo microscope. The studied lymph centres are represented by the dorsal thoracal, ventral thoracal, mediastinal and bronchial lymph centers. No dorsal thoracic lymph centre was identifiable at the investigated animals. The left brhonchial lymph node has a smaller dimension compared to the right bronchial lymph node. The medial mediastinal lymph nodes are identifiable especially on the right side. There were no cranial mediastinal lypmh nodes found during the dissection. The caudal mediastinal lymph nodes were found macroscopical, but is but their presence is advisable to carry out histological examination certification. The present lymph nodes from the thoracic cavity are reduced by number. In the discussion framework it were highlighted the medial mediasnital lymph nodes on the right side. On the right side of the stern, at the level of the second rib, it is well represented the cranial sternal lymph node. This lymph node belongs to the ventral thoracal lymph node and it appears constant as presence. [ABSTRACT FROM AUTHOR]

It has been demonstrated that video-assisted thoracoscopic surgery (VATS) is feasible and safe in humans and animal models. The aim of the present study was to compare the surgical outcome using VATS with that of the standard transthoracic approach for pneumonectomy in dogs, to determine the acute-phase reaction in VATS pneumonectomy, and to analyze the difference between VATS and the standard transthoracic approach. A total of 14 dogs were divided into two groups (n=7); one group underwent VATS and the other group underwent a transthoracic pneumonectomy. Pre-, intraand post-operative physiologic parameters were monitored, in addition to the blood cell count and serum acute-phase protein (APP) concentrations. The APP and hemodynamic changes between the two approaches were analyzed. Mean surgical time in the VATS group (176.7 min) was significantly longer compared with the open group (132.4 min). All APP concentrations were significantly increased at day 1 postoperation and gradually decreased to preoperative concentrations. The serum concentration of C-reactive protein on day 3 and the white blood cell count on day 1 were significantly higher following surgery in the open group compared with the VATS group (P<0.05). No differences were observed in the physiological parameters between the two groups. Although VATS took longer, animals experienced smaller incision and less stress. Therefore, the VATS approach was satisfactory for total pneumonectomy. [ABSTRACT FROM AUTHOR]

Present case report is about very rare condition of gravid uterus herniation into the thoracic cavity and right sided heart displacment in a three year old queen. Cat was presented to obstetrics and gynecology clinic with a history of overdue kittening date. Abdominal cavity was found to have an unusual solid mass in cranial part with little fluid oozing from vulva. Roentgenogram assesment revealed a fetus skeleton in abdomen with two similar skeletons in thoracic cavity and missing a normal diaphragmatic line. Similar findings were recorded on ultrasonography. Midline coeliotomy was done under general gas anesthesia. Diaphragmatic wall had 6 cm left-sided vertically oriented rent in the dorsal aspect with gravid uterine and a 2 cm right-sided vertically oriented in the middle of the diaphragm with liver lobe and gall bladder herniation. Three partially mummified fetuses were recovered. Both diaphragmatic tears were reduced and cat was neutered to avoid future complication. According to available data this is first atypical report in pet practice particularly in feline. [ABSTRACT FROM AUTHOR]

Golden Jackal expansion in Romania is increasing, starting in the southern and south eastern regions to the central regions. This is based on the ability of this species to adapt to different areas and varied diets. In these circumstances, its ecological niche is very broad, favoring the spread. The detailed anatomical descriptions of this species are few, lacking a fair characterization. The aim of this paper is to describe the anatomical peculiarities of the mediastinum in order to compare with scientific reports related to domestic species. Seven specimens were examined. The thoracic cavity was elongated, the lungs and pleural cavities occupying the most part. The mediastinum was referred as a region with three divisions: cranial, middle and caudal. Due to the obvious delineation of its components, the middle mediastinnum was further subdivided in: ventral, middle and dorsal subregions. Due to the caudal position of the heart in the thoracic cavity, the cranial divisions of the mediastinum were large. The reflection of fibrous pericardium on the diaphragm and sternum formed the strong phreno-pericardial ligament and sterno-pericardial ligament. After a short path, the phreno-pericardial ligament followed a divergent path, each part being inserted at the junction of the aponevrotic with fleshy part of the diaphragm. The sterno-pericardial ligament was inserted on the entire dorsal aspect of the sternum, the most compact part connecting the heart apex to the xiphoid process. The results of this study are useful both to the comparative morphological and clinical studies. Based on our results, the differentiation of this specie could be achieved. [ABSTRACT FROM AUTHOR]

Photodynamic therapy (PDT) of the thoracic cavity can be performed in conjunction with surgery to treat cancers of the lung and its pleura. However, illumination of the cavity results in tissue exposure to a broad range of fluence rates. In a murine model of intrathoracic PDT, we studied the efficacy of 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH; Photochlor®)-mediated PDT in reducing the burden of non-small cell lung cancer for treatments performed at different incident fluence rates (75 versus 150 mW/cm). To better understand a role for growth factor signaling in disease progression after intrathoracic PDT, the expression and activation of epidermal growth factor receptor (EGFR) was evaluated in areas of post-treatment proliferation. The low fluence rate of 75 mW/cm produced the largest reductions in tumor burden. Bioluminescent imaging and histological staining for cell proliferation (anti-Ki-67) identified areas of disease progression at both fluence rates after PDT. However, increased EGFR activation in proliferative areas was detected only after treatment at the higher fluence rate of 150 mW/cm. These data suggest that fluence rate may affect the activation of survival factors, such as EGFR, and weaker activation at lower fluence rate could contribute to a smaller tumor burden after PDT at 75 mW/cm. [ABSTRACT FROM AUTHOR]

Purpose: To develop and validate a semiautomatic segmentation method for thoracic cavity volumetry and mediastinum fat quantification of patients with chronic obstructive pulmonary disease. Methods: The thoracic cavity region was separated by segmenting multiorgans, namely, the rib, lung, heart, and diaphragm. To encompass various lung disease-induced variations, the inner thoracic wall and diaphragm were modeled by using a three-dimensional surface-fitting method. To improve the accuracy of the diaphragm surface model, the heart and its surrounding tissue were segmented by a two-stage level set method using a shape prior. To assess the accuracy of the proposed algorithm, the algorithm results of 50 patients were compared to the manual segmentation results of two experts with more than 5 years of experience (these manual results were confirmed by an expert thoracic radiologist). The proposed method was also compared to three state-of-the-art segmentation methods. The metrics used to evaluate segmentation accuracy were volumetric overlap ratio (VOR), false positive ratio on VOR (FPRV), false negative ratio on VOR (FNRV), average symmetric absolute surface distance (ASASD), average symmetric squared surface distance (ASSSD), and maximum symmetric surface distance (MSSD). Results: In terms of thoracic cavity volumetry, the mean ± SD VOR, FPRV, and FNRV of the proposed method were (98.17 ± 0.84)%, (0.49 ± 0.23)%, and (1.34 ± 0.83)%, respectively. The ASASD, ASSSD, and MSSD for the thoracic wall were 0.28 ± 0.12, 1.28 ± 0.53, and 23.91 ± 7.64 mm, respectively. The ASASD, ASSSD, and MSSD for the diaphragm surface were 1.73 ± 0.91, 3.92 ± 1.68, and 27.80 ± 10.63 mm, respectively. The proposed method performed significantly better than the other three methods in terms of VOR, ASASD, and ASSSD. Conclusions: The proposed semiautomatic thoracic cavity segmentation method, which extracts multiple organs (namely, the rib, thoracic wall, diaphragm, and heart), performed with high accuracy and may be useful for clinical purposes. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumors (SFTs) are composed of spindle cells and collagen fibers, and these form rare mesenchymal tumors. SFTs are most frequently observed in intrathoracic sites; however, they may also occur in extrathoracic sites, such as the liver. Unlike the hepatic SFTs (HSFTs) reported in the literature, the SFT detailed in the present case report was a large tumor that originated from the liver, with a dumbbell-shaped growth through the diaphragm into the right thoracic cavity. This posed substantial challenges in both diagnosis and treatment. Thus, the present report outlines the findings of a multidisciplinary team meeting that was used to discuss and develop an optimal and personalized treatment strategy for the patient. Transhepatic arterial embolization was performed to block the major arterial blood supply to the tumor in order to reduce its size. Subsequently, the tumor was fully resected, following the collaboration of the experienced hepatobiliary and thoracic surgeons. Following surgery, the abdominal distension experienced by the patient ceased, and no tumor recurrence was detected at the 1-year follow-up. In conclusion, due to limited previous reports of HSFT treatment using multidisciplinary collaboration, the present study outlined the treatment used for this specific tumor type, and the corresponding literature was reviewed. [ABSTRACT FROM AUTHOR]

Multiple whitish nodules in the thoracic cavity at the site of the thymus were observed in a 101-week-old male ICR mouse. In a histopathological examination, the neoplastic cells were predominantly fusiform in shape and proliferated in sarcomatoid growth patterns. Some neoplastic cells showed epithelial growth patterns, such as the ductal structures. Mitotic figures were frequently seen, and small necrotic foci and invasion to adjacent thoracic organs were noted. In Alcian blue staining, bluish materials were observed between fusiform-shaped cells and in some of the lumens of the ductal structures. In immunohistochemistry, both fusiform-shaped and ductal structure-forming cells were positive for vimentin and weakly positive to positive for cytokeratin. Based on the aforementioned findings, the thoracic nodules were diagnosed as a mixed type of malignant mesothelioma. This case was thought to be rare because of the very low occurrence of spontaneous mesothelioma in mice. [ABSTRACT FROM AUTHOR]

Spontaneous malignant mesothelioma was found in a 104-week-old male Crj:CD(SD) rat. The tumor was scattered on the surface of the lung, heart, mediastinal pleura and thoracic wall and metastasized to the alveolar septa. Histopathologically, small flattened or cuboidal tumor cells proliferated with stroma, formed almost normal papillary structures and reacted positively to colloidal iron stain and immunohistochemical staining for mesothelin. Round hyalinous stromata were pronounced, which is a characteristic feature, and the possible reason for this is as follows; at first, a small amount of collagen fibers was formed in the center of the clusters of several tumor cells, and then the cell clusters expanded like balloons with an increase in the collagen fibers. [ABSTRACT FROM AUTHOR]

The internal organs of rats and rabbits were clearly imaged noninvasively using a deeply penetrating reflection-mode photoacoustic imaging system. This imaging system had previously been found to provide an imaging depth limit of ∼38 mm. In the thoracic cavity, major blood vessels connecting to the heart were imaged, and the right atrium was imaged as deeply as ∼8 mm. In the abdominal cavities, the kidney and vena cava inferior were also imaged in situ. The vena cava inferior ∼13.7 mm deep was imaged. The kidney of a New Zealand white rabbit was also imaged. This study shows the deep internal organ imaging capability of the system in animals. This technology can potentially be used to study tumors in internal organs, and be adapted to clinical diagnosis. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We investigated whether implantation of polylactic acid and epsilon-caprolactone copolymer (PLAC) cubes with or without basic fibroblast growth factor (b-FGF) released slowly from gelatin microspheres was able to induce fibrous tissue in the dead space remaining after pneumonectomy in the thoracic cavity. Methods: Left pneumonectomy was performed in Japanese white rabbits. In the control group (n =6), the left thoracic cavity was closed without any treatment. In the FGF group (n =6), gelatin microspheres that released 100μg of b-FGF were implanted into the left thoracic cavity. In the PLAC group (n =6), PLAC cubes were implanted into the left thoracic cavity. In the PLAC/FGF group (n =6), both PLAC cubes and gelatin microspheres releasing 100μg of b-FGF were implanted into the left thoracic cavity. Results: In the control and FGF groups, herniation of the heart, mediastinal shift, and overinflation of the right lung were observed. No granular tissue formation was observed. In the PLAC and PLAC/FGF groups, a dense area of newly formed soft tissue was observed, and only a mild mediastinal shift was observed during the 3-month follow-up period. Pathological examination revealed induction of fibrous and granular tissue in the left thoracic cavity. The foreign-body reaction induced by PLAC was very mild. Conclusions: Implantation of PLAC cubes with or without gelatin microspheres releasing 100μg of b-FGF is able to induce fibrous tissue in the post-pneumonectomy dead space. [Copyright &y& Elsevier]

Background: Recently there has been an increasing enthusiasm for using natural orifices translumenal endoscopic surgery (NOTES) to perform scarless abdominal procedures. We have previously reported the feasibility and safety of the transvesical endoscopic peritoneoscopy in a long-term survival porcine model as useful for those purposes. Herein, we report our successful experience performing transvesical and transdiaphragmatic endoscopic approach to the thoracic cavity in a long-term survival study in a porcine model.Methods: Transvesical and transdiaphragmatic endoscopic thoracoscopy was performed in six anesthetized female pigs. A 5 mm transvesical port was created on the bladder wall and an ureteroscope was advanced into the peritoneal cavity. After diaphragm inspection, we introduced through the left diaphragmatic dome a ureteroscope into the left thoracic cavity. In all animals, we performed thoracoscopy as well as peripheral lung biopsy. Animals were sacrificed by day 15 postoperatively.Results: We easily introduced a 9.8 Fr ureteroscope into the thoracic cavity that allowed us to visualize the pleural cavity and to perform simple surgical procedures such as lung biopsies without complications. There were neither respiratory distress episodes nor surgical complications to report. Postmortem examination revealed complete healing of vesical and diaphragmatic holes, whereas no signs of infection or adhesions were observed in the peritoneal or thoracic cavities.Conclusion: This study demonstrates the feasibility of transvesical thoracoscopy in porcine model. However, although this study extends the potential applications of NOTES to the thoracic cavity, new instruments and further work are needed to provide evidence that this could be translated to humans and with advantages for patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the contact and knowledge about the care of chest drains among nurses. Methodology: In this study, an integrative review was carried out, using the combination of the components of the PICO strategy for the bibliographic search that was carried out in the Science Direct and Google Scholar databases, with the descriptors "nurse" AND "chest drain" OR " chest tube". As selection criteria, articles from 2013 to 2021 published in nursing journals were applied. Results: According to the articles found, attentive and specialized nursing care is essential in the prevention of serious complications in patients with a chest tube and drainage system, as well as the need for quality technical knowledge in the management of the chest tube. Conclusion:There was a scarcity of Nursing studies with focused on drains management that leave gaps in their care, as well as promotes nursing professionals distancing from the language standardization systems that would facilitate their practice. [ABSTRACT FROM AUTHOR]

Fracture and intrathoracic displacement of the humeral head is the result of severe high energy trauma and are extremely rare. Because of the exceedingly limited number of cases, appropriate treatment modality remains unclear. Hitherto, we describe a unique case of thoracic aorta injury caused by fragmented humeral head. Purposeful medical examination and fast locating of the humeral head fragment are crucial for the selection of appropriate treatment modality. Early aggressive intervention, e.g., emergency thoracoscopy exploring, can be performed to treat potential thoracic complications. [ABSTRACT FROM AUTHOR]

Cardiac herniation is a fatal complication in patients undergoing pneumonectomy with pericardial resection. A 53-year-old man underwent right-sided extrapleural pneumonectomy for malignant pleural mesothelioma. He underwent right-sided pericardial resection and reconstruction with an expanded polytetrafluoroethylene sheet. Routine chest radiography performed 18 h postoperatively revealed cardiac herniation into the right-sided thoracic cavity. The patient was immediately transferred to the operating room, and the defect was repaired. He died of tumor progression. However, cardiac herniation did not recur over 2 years postoperatively. [ABSTRACT FROM AUTHOR]

This case report shows a very rare case series of one family with four children who had severe congenital sliding hiatus hernia (HH) with uncommon presentations, and they had one parent with sliding hernia and the other with reflux symptoms. It is rarely described in the literature a direct link to a familial type that might refer to a common genetic factor. Hiatus hernia is protrusion of abdominal viscera through the oesophagus opening in the diaphragm into the thoracic cavity with sliding hernia being the most common. It can be either asymptomatic or accompanied by a variety of symptoms. We present a case series of one family in which four siblings had congenital sliding diaphragmatic hernia with atypical symptoms and gastro-oesophageal reflux disease (GORD). It is a rare case that suggests a common factor that can cause such a common disease. All four had uncommon presentations which all required surgical repair. Few cases reported on the medical literature, and they were discussed and compared with our case. However, we need further studies in families that might have this phenomenon. [ABSTRACT FROM AUTHOR]

This paper describes a rare case presentation of congenital asymptomatic intrapericardial diaphragmatic hernia. In this case, the female patient survived without symptoms for over 30 years until becoming symptomatic at childbirth. Diaphragmatic hernia occurs when abdominal viscera protrude into the thoracic cavity, with pericardial hernias being the rarest type. Diaphragmatic hernia can be caused by trauma that raises the intra-abdominal pressure, whereas congenital hernias are often symptomatic at birth. It is rare to have a congenital asymptomatic intrapericardial diaphragmatic hernia, where the patient survives until adulthood and subsequently becomes symptomatic after delivering a child; hence, that is the uniqueness of this case. [ABSTRACT FROM AUTHOR]

Malignant triton tumor (MTT) is a rare subtype of malignant peripheral nerve sheath tumors with rhabdomyoblastic differentiation. Although the condition may manifest sporadically, it typically affects adult patients with neurofibromatosis type 1. In this article, an extremely rare case of MTT with chest wall origin, which expanded into the left thoracic cavity, is reported. A 64-year-old male was admitted to the institution with sudden shortness of breath. Radiological examination revealed a large mass with massive pleural effusion occupying the patient's left hemithorax. A percutaneous needle biopsy was performed and the patient underwent subtotal tumor resection with left pleuropneumonectomy. Immunohistochemical study of postsurgical pathologic specimens confirmed the diagnosis of MTT. Despite extensive surgical removal, tumor recurrence was reported soon after resection, leading to patient's death 20 days after surgery due to acute respiratory failure. Investigation of rare MTT cases is necessary for understanding this condition. [ABSTRACT FROM AUTHOR]

Background: Fibrolipoma is an uncommon subtype of lipoma. On the basis of the results of a survey of the PubMed database, only approximately a dozen cases in children have been described in which the histological diagnosis of fibrolipoma has been confirmed. In children, fibrolipomas have been reported in the eyelids, ears, lips, nasopharynx, mouth, and other locations but not in the thoracic cavity. We present the case of a 15-year-old girl with a giant fibrolipoma in the left side of her thoracic cavity.Case Presentation: A 15-year-old Chinese girl presented with chest tightness and exercise-induced shortness of breath of 4 months' duration. Computed tomography revealed a giant mixed-density space-occupying lesion in the left side of her thoracic cavity, originating possibly from the pleura. Radiological findings were inconclusive and failed to exclude malignant mesenchymal tumor. After excluding malignant tumor with two needle biopsies and identifying the tumor's feeding blood vessels by computed tomography angiography examination, our treatment plan was, first, embolization of the tumor's blood vessels by digital subtraction angiography and, second, to remove the tumor by thoracotomy.Conclusions: Thoracic fibrolipoma in children is rare; its treatment is complete resection of the tumor. Pathological examination of the removed tissue is the gold standard for diagnosis. Early computed tomography and magnetic resonance imaging examinations are helpful to determine the extent and nature of the tumor and to reduce damage of the surrounding organs. Preoperative examination of tumor markers, ultrasound-guided biopsy, and preoperative digital subtraction angiography tumor vascular embolization are important preoperative preparations to ensure surgical resection. [ABSTRACT FROM AUTHOR]

Bochdalek hernias are diaphragmatic defects seen in pediatrics. About 5–25% of the cases are diagnosed in adulthood, and present with symptoms of chest and abdominal problems. This is a case of an 18-year-old male who presented to the emergency department with epigastric pain, vomiting and dyspnea. Most of the left-sided organs had herniated to the left chest cavity. Immediate surgery was performed. The stomach, spleen and colon were reduced into the abdominal cavity. The diaphragm defect was repaired laparoscopically, but there were limitations due to inadequate space, leading to difficult visualization of the posterior diaphragmatic leaflet. A thoracoscopic approach was taken where we saw the left kidney herniated through the repair site posteriorly. It was reduced and the defect was closed. The early diagnosis of Bochdalek hernias is important to prevent stomach/intestinal strangulation. Laparoscopic surgeons need to be prepared for a thoracic approach in giant congenital diaphragmatic hernias. [ABSTRACT FROM AUTHOR]

To the best of our knowledge, there have been no previous reports of chylothorax developing after pancreatectomy, although chylous ascites can occur. In patients with a pleuroperitoneal communication, ascitic fluid can flow into the thoracic cavity through a small hole in the diaphragm. A 70-year-old woman underwent total pancreatectomy and was referred to our department for treatment of right chylothorax after removal of her abdominal drainage tubes. An occult pleuroperitoneal communication was detected, and the portion of the diaphragm containing a diaphragmatic fistula was resected using a surgical stapler. After surgery, the chylothorax resolved, but chylous ascites developed. We speculated that this was a rare case of chylous ascites that flowed into the thoracic cavity through a diaphragmatic fistula after a pancreatic resection. When a patient develops chylothorax after an abdominal operation, the combination of a pleuroperitoneal communication and chylous ascites must be considered. [ABSTRACT FROM AUTHOR]

Diaphragmatic hernias are either congenital or acquired defects in the diaphragm that permit passing of abdominal contents into the chest cavity. Individuals with large diaphragmatic hernias associated with a gastric perforation have rarely been reported in literature and can have serious mortality rates. Herein, we present a case of gastric perforation in the setting of a significant sized diaphragmatic hernia. The value of the current report compared to previously published cases is the sub-acute nature and lack of any indicative features on initial presentation which can lead to misdiagnosis and serious morbidity later in life. [ABSTRACT FROM AUTHOR]

A 45-year-old woman was referred to our hospital with sudden chest pain. She came on foot with normal vital signs. Computed tomography (CT) revealed right mild pneumothorax with niveau level. We suspected spontaneous hemopneumothorax (SHP) and inserted a thoracic drain. After 800 ml of blood and air was evacuated immediately, the outflow from the drain stopped. However, despite the outflow of blood from the drainage tube having stopped, she developed hemorrhage shock 2 h after drainage. Contrast-enhanced CT revealed extra-vascular signs at the top of the right pleural cavity. Emergency video-assisted thoracic surgery (VATS) was performed. We identified the chest drain as being obstructed by blood clot. Continuous bleeding from a small aberrant vessel at the top of the thoracic cavity was identified, and we stanched it easily by clipping. The present experience suggests that routine enhanced CT and aggressive emergent VATS should be performed in cases of SHP. [ABSTRACT FROM AUTHOR]

A 64-year-old man underwent right upper lobectomy combined resection with third-fifth rib for lung cancer and reconstruction of chest wall using Dual Mesh. Six days after surgery, he experienced acute severe pain in the right shoulder. The purulent drainage through the drainage tube was also found. Chest CT showed that the inferior angle of the scapula protruded into the right intrathoracic cavity. We performed a removal of Mesh. Although we did not want to use synthetic materials because of infection, we performed titanium plate fifth rib fixation to avoid the recurrent dislocation of the scapula. After the redo surgery, continuous lavages with physiologic saline of the thoracic cavity was also performed. Patient is now doing well without recurrences of cancer, infection and scapular dislocation, 14 months after the redo surgery. [ABSTRACT FROM AUTHOR]