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Teratomas are tumors consisting of tissues derived from more than one germ cell line. Usual locations are sacrococcygeal region, intracranial, mediastinum, and gonads. Entirely intrapulmonary teratomas, with no mediastinal component, are rarely reported. We present the case of a 37-year-old man who presented for evaluation due to persistent and progressive intermittent cough. There was no sputum or hemoptysis. Computed tomography (CT) revealed an irregular, cystic lesion in the upper lobe of his left lung, which raised suspicion for aspergilloma. The patient underwent a left thoracotomy and, after finding a completely collapsed and hypoplastic left lung almost entirely occupied by an irregular mass, a total left pneumonectomy was performed. Pathological review reported an entirely intrapulmonary mature teratoma. Intrapulmonary mature teratomas are extremely rare, although several have been reported. Trichoptysis (expectoration of hair) is a specific finding that may help distinguish this entity from mediastinal teratomas., Competing Interests: Conflict of interestThe authors declare no competing interests., (© Indian Association of Cardiovascular-Thoracic Surgeons 2021.)

Lambert-Eaton syndrome is a rare paraneoplastic disorder of the neuromuscular junction, characterized by impaired release of acetylcholine, which causes proximal muscle weakness, depressed tendon reflexes, and autonomic changes. Most cases of Lambert-Eaton syndrome present in small-cell lung carcinoma, and only a few cases have been reported in other lung subtypes. Herein, we report a case of 69 years old male patient with Lambert-Eaton syndrome as a rare association with a pulmonary large-cell neuroendocrine carcinoma, which presented 5 months before neoplasm diagnosis. A lobectomy was auspiciously performed. A review of the literature is also presented., Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2021.)

Experience with conventional repair of peripheral nerves clearly indicates that there is still room for improvement, mainly in so far as functional results are concerned. It appears that the present microtechnique has reached its limitation given by physical and technological means, materials and methodology. The use of CO2 laser was tried on rat sciatic nerve. An equal number of nerves were severed surgically and sutured, using microsuture technique in one group and the same number of nerves were repaired using the CO2 laser technique. For the setting of the parameters, optimal for our purpose of reuniting the tissues, we have utilised morphological and electrophysiological qualitative and quantitative characteristics. The results were assessed by comparing both functionally and morphologically, the functional comparison being made electrophysiologically and the morphological comparison microscopically and morphometrically. The comparison shows a larger degree of scarring and constriction of the nerves anastomosed by classical microsuture than that of the laser technique. Action potentials going through the anastomosis have been noticed in both groups without significant difference in quality of CMAP, with the exception the latency.

It outflows from a survey of 174 cases operated during five years for skull injuries that the resulting state depends of preoperative level of consciousness. In injuries with the loss of consciousness, there is a close correlation between the type of motor-topain response and the resulting state. It was stated from the delay for up to 5 years after surgery that the independence from the day life has been achieved in 65% of injured patients which experienced preoperatively a mild loss of consciousness as they localized the pain stimulus or produced unintelligible sounds in response to pain. The similar condition has been achieved in only 14% cases of preoperatively deep loss of consciousness, which responded to pain or not with decerebrative extension, or unconsciously flexion of extremities. The resulting state is less dependent of operative diagnosis. Epidural hematomas show better results, where the independence of the day life has been achieved in 62% of cases. The majority of them was able to perform their previous working activities later on. In contrast, the worst results were achieved in association with brain contusions, where only 18% of injured patients sustained the independence of environs with no return to the previous work. Prognostically, the factor of age is the most important. In the age group over than 60 years, the mortality represented 58%, whereas in 20-40 years of age it was only 24%.