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Objectives: This study aimed to clarify the relationship between preoperative sarcopenia and prognostic nutritional index (PNI) statuses and clinicopathological factors in patients with non-small cell lung cancer (NSCLC) who underwent surgical resection, and to evaluate short- and long-term outcomes by stratifying groups according to sarcopenia and PNI status as prognostic predictors., Materials and Methods: This study included 300 patients with p-Stage I-IIIA NSCLC who underwent complete resection with lobectomy. Sarcopenia was assessed using the skeletal muscle index (SMI) and the immunonutritional index was evaluated using the PNI. The first quartile was used as the cutoff for the sarcopenia/non-sarcopenia and low/high-PNI groups., Results: The median patient age was 70 years, and 184 patients (61.3 %) were male individuals. The median PNI was 50.2, and the median SMI was 48.1 and 37.5 for male and female patients, respectively. The median follow-up period was 64 months (60 patients died). Survival analysis showed that overall survival was significantly worse in the sarcopenia and low-PNI groups than in the control group (p = 0.002 and p < 0.001, respectively). When stratified by sarcopenia and PNI status, the sarcopenia with low-PNI group had a particularly poor prognosis (5-year survival rate, 52.8 % [p < 0.001]). Multivariable Cox regression analysis revealed that sarcopenia with low PNI was an independent prognostic factor that indicated a poor outcome. The response to drug treatment for postoperative recurrence was significantly worse in the sarcopenia with low-PNI group than inthe other group., Conclusion: The combination of preoperative sarcopenia and immunonutritional impairment had a negative clinical impact independent of tumor factors, and patients with these two indications had a particularly poor prognosis. These factors may be associated with poor responses to drug treatment for postoperative recurrence. The evaluation of skeletal muscle mass using preoperative imaging and nutritional assessment using serum markers may be useful for perioperative management and prognosis prediction., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Purpose: Though programmed cell death-1 (PD-1) inhibitors mainly target tumor-infiltrating lymphocytes (TILs) expressing PD-1, developing T cells in thymus also express PD-1 in their process of maturation. To predict the therapeutic effect of PD-1 inhibitors for thymoma, it is necessary to clarify the proportions of TILs and intratumoral developing T cells., Methods: The expressions of CD4, CD8, and PD-1 on T cells were analyzed by flow cytometry in 31 thymomas. The amount of T cell receptor excision circles (TRECs), which can be detected in newly formed naïve T cells in the thymus, was evaluated using sorted lymphocytes from thymomas by quantitative PCR. The expressions of granzyme B (GZMB) and lymphocyte activation gene-3 (LAG-3) in PD-1 + CD8 T cells were analyzed by image cytometry using multiplex immunohistochemistry., Results: The PD-1 + rate in both CD4 and CD8 T cells was significantly higher in type AB/B1/B2 than in type A/B3 thymomas. The amounts of TRECs in CD4 and CD8 T cells were significantly higher in type AB/B1/B2 than in type A/B3 thymomas and comparable to normal thymus. PD-1 expression at each stage of T cell development of type AB/B1/B2 thymomas was comparable to that of normal thymus. Both the percentages and cell densities of PD-1 + CD8 T cells expressing GZMB or LAG-3, which are known to contain tumor-reactive T cells, were significantly lower in type AB/B1/B2 thymomas., Conclusion: Most PD-1 + T cells in type AB/B1/B2 thymomas are intratumoral developing T cells and are not TILs., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Mesenchymal cystic hamartoma is a rare pulmonary neoplasm, which occasionally presents with severe symptoms such as pneumothorax or hemothorax, and shows favorable outcomes following surgical resection. It presents as solitary or multiple cystic lesions and requires differentiation from cystic malignancies, lymphangiomyomatosis, and cystic adenomatoid malformation., Case Presentation: We encountered a 46-year-old woman with mesenchymal cystic hamartoma mimicking simple pulmonary aspergilloma on diagnostic imaging. Chest computed tomography showed a cystic lesion 1.6 cm in diameter, with an intracavitary nodule. Surgical resection proved neither fungus nor malignancy, and the final pathological diagnosis of mesenchymal cystic hamartoma was made., Conclusions: Mesenchymal cystic hamartoma might show aspergilloma-like features on diagnostic imaging, in addition to the differential diagnosis of lung cancer., (© 2023. The Author(s).)

Purpose: Intraoperative control of air leaks is important for preventing prolonged air leaks after surgery. The usefulness of suturing free pericardial fat pads (FPFPs) as pledgets for repairing air leaks was investigated., Methods: A total of 111 patients who underwent anatomical lung resection and required suture repair for intraoperative air leaks were retrospectively reviewed. Mattress sutures were performed using polyglycolic acid (PGA) sheets (PGA group; n = 60) in the early period (April 2014 to March 2018) and FPFPs (FPFP group; n = 51) in the late period (April 2018 to March 2021) as pledgets., Results: More patients had a history of smoking in the FPFP group than in the PGA group. The duration of air leakage was significantly shorter (mean 1.2 vs. 3.5 days, p = 0.002) and prolonged air leakage (> 5 days) was less frequently observed (23.3% vs. 5.9%, p = 0.016) in the FPFP group than in the PGA group. The FPFP group had fewer cases requiring pleurodesis and with recurrent air leaks than in the PGA group. In one case in the FPFP group, fat necrosis with fibrosis and fibrous adhesion to the visceral pleura was found on a pathological examination., Conclusion: Parenchymal repair using FPFPs as pledgets can reduce prolonged air leaks after surgery., (© 2022. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.)

Postoperative aneurysmal formation of the anomalous artery stump has been reported in the systemic arterial supply to the basal segment of the left lung, whereas the effective preventive strategy remains unclear. Herein we report a case successfully treated with a new external corset technique of an anomalous artery stump. A 54-year-old man with a history of repeated hemoptysis underwent a left lower lobectomy. The anomalous artery stump with a 1.1 cm diameter was wrapped using woven Dacron vascular graft. No aneurysmal change has been observed in the computed tomography obtained after 3 years of follow-up., (Copyright © 2021 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Background: The prognostic nutritional index (PNI), an immune nutritional marker based on serum albumin levels and total lymphocyte count, predicts postoperative complications in various types of malignancies. However, the clinical significance of the PNI for postoperative complications following lung cancer surgery is uncertain., Methods: Patients with resected non-small cell lung cancer (n = 515) were retrospectively analyzed and the relationship between the preoperative PNI and postoperative complications was evaluated., Results: Multivariate logistic regression analysis revealed that a preoperative low PNI was a significant independent predictor of postoperative complications of Clavien-Dindo Grade ≥ II (odds ratio: 1.06 per unit decrease, 95.0% confidence interval 1.01-1.11). Patients were divided into three groups according to the preoperative PNI: normal (≥ 50; n = 324), mildly low (< 50, ≥ 45; n = 134), and severely low (< 45; n = 57). The incidence of postoperative complications of Grade ≥ II and Grade ≥ III in the normal, mildly low, and severely low PNI groups was 22.2, 39.6, and 42.1% and 7.1, 16.4, and 22.8%, respectively. The incidence of postoperative complications of Grade ≥ II and Grade ≥ III was significantly higher in the mildly low and severely low PNI groups than in the normal PNI group (p < 0.001 and p < 0.001, respectively). The incidence of air leak, pneumonia, and extrapulmonary infection, but not arrhythmia, was significantly higher in the mildly low and severely low PNI groups than in the normal PNI group., Conclusions: The PNI could be a useful marker to predict the risk of postoperative complications after lung cancer surgery.

A 38-year-old man with bilateral Pryce III intralobar sequestration was admitted. At first, left lower lobectomy and division of the aberrant artery were performed because of continuous hemoptysis after admission. Two months later, we planned a video-assisted thoracoscopic wedge resection of the right sequestration and a division of the 2 aberrant arteries. We chose indocyanine green fluorescence navigation because of the small volume of the right sequestration, with a goal to reduce respiratory functional loss as much as possible. After the aberrant arteries and the small pulmonary vein of the sequestration were transected, the boundary of the sequestration was observed clearly using infrared thoracoscopy. In patients with a small sequestration with recurrent episodes of infections and low respiratory function, indocyanine green fluorescence navigational technique is considered useful., (Copyright © 2017. Published by Elsevier Inc.)

Immobilized bacteria are being assessed by industry for drug delivery, novel fermentation systems and the protection of organisms in harsh environments. Alginate bioreactors containing Streptomyces nodosus were examined for community structure, cell viability and amphotericin production under different growth conditions. When cell proliferation was encouraged, substrate hyphae were found inside the alginate matrix and within multicellular projections on the surface of the capsule. The periphery of these projections had erect and branched hyphae, morphologically identical to aerial hyphae. Antibiotic production from immobilized organisms was assessed using conditioned culture medium to eliminate the emergence of a free-dwelling population. These organisms sporulated with reduced antibiotic production compared with free-dwelling cultures. The commitment to sporulate was independent of a surface but dependent on community size and nutritional status. This is the first report of the sporulation of S. nodosus in liquid cultures and description of the multicellular community the organism adopts at a solid-liquid interface., (© 2008 The Authors. Journal compilation © 2008 Society for Applied Microbiology and Blackwell Publishing Ltd.)

Polyketides are a group of bioactive compounds from bacteria, plants, and fungi. To increase the availability of analogs for testing, the active sites of polyketide synthases are often substituted with homologous domains having altered substrate specificities. This study reports the design of polymerase chain reaction primers that enables isolation of entire active site domains from type I polyketide synthases with native interdomain linkers. This bypasses the need for further genetic screening to obtain functional units for use in genetic engineering. This is especially important in bioprospecting projects exploring new environments for bioresources.