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Background: We recently reported that high-risk human papillomavirus (HPV) 16/18 E6 protein was associated with p53 protein degradation in lung cancer. The present study addressed the relationship between the different p53 genotypes and HPV oncoprotein expression with respect to p53 protein degradation and clinical outcome in primary lung cancer patients. Methods: We examined whether p53 codon 72 polymorphism and HPV oncoprotein expression could be associated with patients'' outcome by collecting 319 lung tumors from patients with non-small cell lung cancer to determine p53 codon 72 polymorphisms, HPV 16/18 infection, and HPV 16/18 E6 and p53 protein expression by polymerase chain reaction (PCR)-restriction fragment length polymorphism, nested-PCR, and immunohistochemical analysis. Results: The presence of HPV 16/18 DNA and E6 protein was inversely associated with p53 expression. The frequency of p53 protein degradation was also much higher in HPV 16/18 E6-positive/Arg/Arg lung tumors than in the other 3 groups. After adjusting gender and tumor type, the major contributors to p53 degradation in lung cancer patients were determined to be p53 codon72 polymorphism and HPV 16/18 E6 oncoprotein expression. This association was not found for HPV 16/18 DNA infection. Survival was significantly longer in patients with HPV 16/18 E6-negative/Arg/Arg tumors (median 32.7 months) than in patients with HPV-positive and p53 genetic variant tumors (p = 0.008). Conclusions: The HPV 16/18 E6 protein, which is involved in the p53 inactivation that contributes to HPV-infected lung tumorigenesis, is associated with the p53 codon 72 genotype. The combination of HPV 16/18 E6 status and p53 codon72 polymorphism in lung tumors is an important biologic and prognostic parameter. [Copyright &y& Elsevier]

Malignant triton tumor is a rare malignant peripheral nerve sheath tumor with rhabdomyoblastic differentiation. Most of these tumors are located in the head, neck, and extremities, and about half of cases are associated with neurofibromatosis type 1 featuring cafe-au-lait spots or cutaneous neurofibromas. We present a 76-year-old man with an insidious chest wall tumor with late progressive painful enlargement and pleural and pulmonary involvement. Complete resection of the affected thoracic wall as well as single separate lesions in the parietal pleura and left upper lung was carried out. The pathological examination confirmed that it was a malignant triton tumor. The patient received adjuvant chemoradiotherapy but eventually succumbed to disease relapse and distant metastases 6 months after the surgery. [ABSTRACT FROM AUTHOR]

Abstract: Empyema thoracis is a complex pleural infection disease that can evolve into three pathological phases: exudative, fibrinopurulent, and organized. Each stage presents with its own characteristics and relevant treatment strategies. Organized empyema, defined as pleural fibrosis with peel formation, often requires thoracotomy and decortication to expand the entrapped lung. In chronically ill, debilitated, or elderly patients superimposed with organized empyema, more invasive operative approaches are likely to result in higher procedure-related morbidities and mortalities. On the other hand, less invasive procedures would also be inappropriate because of frequently ineffective drainage or consistent lung encasement (e.g. prolonged catheter insertion, intrapleural fibrinolysis, or thoraco-scopic debridement). Here, we report two elderly patients with concomitant illnesses who developed organized empyema and had no response to nonoperative management. Both patients recovered completely after video-assisted thoracoscopic surgery debridement, proper chest tube placement, and urokinase instillation to resolve residual thick peels. Less invasive surgical treatment combined with the use of fibrinolytic agents may be an option in treating patients with organized empyema who cannot tolerate decortication. [Copyright &y& Elsevier]

O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation has been demonstrated to associate with the G:C→A:T transition mutation in the p53 gene of lung tumors. The purpose of this study is to clarify whether MGMT promoter methylation is not only associated with the shift from the G:C→A:T mutation in the p53 gene but also whether MGMT increases other mutation patterns in lung tumors. To further verify whether a different prevalence of MGMT promoter methylation is observed in lung tumors with a different tumor histology, gender, and smoking status, 220 lung tumors were collected to evaluate the status of MGMT promoter methylation and p53 mutation using methylation-specific PCR (MSP) and direct sequencing, respectively. The data shows that a higher prevalence of MGMT promoter methylation was observed in tumors with the G:C→A:T transition or other p53 mutation patterns compared with those with p53 wild-type ( P < 0.001 for G:C→A:T; P = 0.015 for other mutation patterns), and this prevalence was more pronounced in tumors from male than from female patients. MGMT promoter methylation in p53 mutation patterns had a different effect on squamous cell carcinomas (SCC) and adenocarcinomas (ADC). Interestingly, the highest prevalence of MGMT promoter methylation was found in male nonsmokers followed by male smokers and female nonsmokers. This may be a partial explanation for the reason why male nonsmokers had a higher p53 mutation occurrence than female nonsmokers. MGMT promoter methylation may associate with increased occurrence of p53 mutation including the G:C→A:T transition and other p53 mutation patterns in lung cancer, especially among male nonsmokers. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop a web-based short messaging service (SMS) system in the operating room (OR). At the same time, we integrated and analyzed the limits of SMS in the OR. A cross-sectional study with quantitative methods and convenience sampling was used to gather data in this study. In the SMS project, we approached the content of SMS with operation diagnosis, patient sources and time series (pre-, intra-, and post-operation). We also default the contents of SMS by patient individual conditions. In this study, 177 participants received 346 text messages and 139 participants answered satisfaction questionnaires (78.53 %). The findings show the usability of SMS as applied to clinical care, especially for reducing family anxiety, for real time information, physician-patient communication, medical care processes and patient safety. Therefore, it is suggested to exploit the effectiveness of a personal medical care information database under global goal in the future and to develop comprehensive management of the surgical patient relationship. [ABSTRACT FROM AUTHOR]

Propolis is a resinous substance collected by bees as a sealant for their hives. It is also used in traditional medicine as an antioxidant and antiinflammatory agent to treat ulcers, superficial burns, and microbial diseases. In this report, a 40-year-old woman who took liquid propolis for relief of her common cold experienced severe sore throat, dysphagia, and easy choking followed by fever and chills. Descending necrotizing mediastinitis and concomitant aspiration pneumonia were evident on the image studies. We performed video-assisted thoracoscopic surgery to achieve immediate and adequate drainage, and the patient resumed normal deglutition 2 months later. Early diagnosis and prompt video-assisted thoracoscopic surgery intervention are paramount to manage this life-threatening situation. [Copyright &y& Elsevier]