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Background Tumor with adjacent lobe invasion (T‐ALI) is an uncommon condition. Controversy still exists regarding the optimal resection of adjacent lobe invasion, and the prognostic value in relation to fissure integrity at the tumor invasion point. The aims of this paper were to evaluate the prognosis of T‐ALI with regard to fissure integrity, and type of resection. Methods This was a retrospective multicenter study which included all consecutive patients with T‐ALI undergoing surgical treatment. Based on radiological, intraoperative and histological findings, T‐ALI patients were differentiated into two groups based on whether the fissure was complete (T‐ALI‐A group) or incomplete (T‐ALI‐D Group) at the level of tumor invasion point. Clinico‐pathological features and survival of two study groups were analyzed and compared. Results Study population included 135 patients, of these 98 (72%) were included into T‐ALI‐A group, and 37 (38%) into T‐ALI‐D Group. T‐ALI‐D patients had better overall survival than T‐ALI‐A patients (63.9 ± 7.0 vs. 48.9 ± 3.9; respectively, P = 0.01) who presented with a higher incidence of lymph node involvement (35% vs. 4%; P = 0.004), and recurrence rate (43% vs. 16%; P = 0.01). At multivariable analysis, T‐ALI‐D (P = 0.01), pN0 stage (P = 0.0002), and pT≤5 cm (P = 0.0001) were favorable survival prognostic factors. Conclusions T‐ALI‐D presented a better prognosis than T‐ALI‐A while extent of resection had no effect on survival. Thus, in patients with small T‐ALI‐D and without lymph node involvement, sublobar resection of adjacent lobe rather than lobectomy could be indicated. Key points The extent of resection of adjacent lobe had no effect on survival while T‐ALI‐D, pN0 stage, and pT≤5 cm were significant prognostic factors. In patients with small T‐ALI‐D and without lymph node involvement, sublobar resection of adjacent lobe could be indicated as an alternative to lobectomy.

Eastern Shore Agricultural Research and Extension Center Virtual Research Field day includes various presentations and publications of the authors’ above, which are each linked in the body of the publication NP

BACKGROUND: Increased age of cancer patients is not an absolute contraindication to pulmonary resection. Different scores have been developed to determine the risk of morbidity and mortality. We have compared four scores in a series of elderly patients with primary or metastatic lung neoplasms who underwent pulmonary resection. METHODS: Data from 150 patients with an age equal or more than 75 years were reviewed. Mean age was 78.3 (range, 75–86) years. Based on medical history and preoperative tests 4 predicting scores were calculated. Statistical analysis was performed to identify which score correlates better with postoperative morbidity and mortality. RESULTS: Mortality at 30 days was observed in 3 patients (2%). Postoperative morbidity was observed in 38 patients (25.3%). Univariate analysis showed that risk factors significantly predicting the onset of postoperative complications were type of resection (P=0.02), American Society of Anesthesiology (ASA) score (P

We describe a rare case of Dirofilaria repens infection presenting as peripheral lung nodules and mimicking a metastatic focus from a previously diagnosed cutaneous melanoma. To avoid invasive investigations before arriving at the correct diagnosis, dirofilariasis should be included as a part of the diagnostic process in subjects with lung nodules who live in (or have traveled to) endemic regions.

Introduction Malignant diseases are well-known complications after lung transplantation (LT). Among these, inflammatory myofibroblastic tumor (IMT) is a rare neoplasm with a not well-known and often aggressive biological behavior. Material and Methods We hereby describe 2 cases of cystic fibrosis patients who underwent bilateral sequential LT (BSLT) complicated by IMT. Results A 26-year-old man presented a right endobronchial lesion 6 months after BSLT. Two consecutive fiber bronchoscopic biopsies showed granulation tissue. For the persistent lesion growth, the patient underwent a transthoracic biopsy showing histologic diagnosis of IMT. Therefore, he underwent to right pneumonectomy that was unfortunately complicated after 6 months with a late bronchopleural fistula and empyema with exitus 6 months later. A 31-year-old woman 1 year after BSLT presented with a left voluminous pleural-parenchymal lesion; the histologic examination after biopsy revealed an IMT. She underwent a removal of the lesion with a macroscopic R0 resection. Histologic, immunophenotypic, and cytogenetic examinations showed a strong overexpression of anaplastic lymphoma kinase requiring biological adjuvant therapies; however, the patient refused it. Four years later, she presented a recurrence treated with debulking procedure and adjuvant radiotherapy. At last follow-up, the patient was alive with stable disease and optimal graft function. Conclusions Although IMT is a rare complication after lung transplant, to obtain a careful diagnosis, an early and aggressive treatment is mandatory.

In the last three decades, minimally invasive techniques have progressively gained acceptance, as shown by the numerous studies published in the literature. Before the 1990s, video-assisted thoracoscopic surgery (VATS) was considered feasible almost exclusively for the diagnosis of pleural diseases. The availability of better instruments and endoscopic stapling devices allowed thoracoscopy to evolve into a new “therapeutic era”. Nowadays, VATS is considered the approach of choice for the treatment of pneumothorax and other lung, mediastinal and esophageal diseases, replacing traditional approaches as thoracotomy and sternotomy. The use of ports through small incisions (one to three-four) for the camera and surgical instruments allows the surgeon to explore the pleural cavity and work easily on the lung parenchyma. This approach translates into less discomfort for the patient, reduced morbidity, shorten hospital stay and faster functional recovery. The optimal treatment of pneumothorax certainly refers thoracoscopy as the approach of choice maintaining the same indications as for open surgery.

Background: Mucosa associated lymphoid tissue (MALT) lymphoma of the thymus is rare and generally associated with autoimmune disorders. It is generally suspected in middle-aged asian women with Sjogren’s syndrome or other autoimmune diseases presenting a multicystic mediastinal mass. Contrary to other MALT lymphomas, the etiology of these tumors is still uncertain especially those affecting patients with no autoimmune diseases. Thymic MALT lymphoma with simultaneous salivary gland involvement is extremely rare, with only few cases described in literature. Case presentation: We present a case of a 33 years-old male, with a recent history of MALT lymphoma of right parotid gland, affected by thymic mass. The patient underwent a right video-assisted thoracoscopy with radical thymectomy. The histological examination revealed a MALT lymphoma of the thymus. The molecular analysis on both thymic and parotid MALT lymphoma for clonal rearrangement of the immunoglobulin heavy chain gene suggests the origin from the same lymphomatous clone. Conclusions: It is still unclear if multiple localizations of MALT lymphomas are attributable to the development of different primary lymphomas or can be caused by lymphatic metastatic spread. Our analysis reveal that the hypothesis of metastatic spread cannot be excluded in patients with simultaneous MALT lymphoma of the thymus and parotid gland, especially in non-autoimmune related MALT lymphomas.

Background: This retrospective study is designed to evaluate factors affecting survival in a population of patients receiving pulmonary metastasectomy after gynecologic cancers. Methods: Nineteen patients with isolated lung metastases (one or two) were surgically treated with R0 resection. Four of them underwent lobectomies. Results: Six patients (31.6%) received adjuvant therapy and 11 (58%) experienced recurrences after metastasectomy. Five- and ten-year survival were 40.9% and 31.4%, respectively. Five-year survival in patients receiving adjuvant therapy was 52.4%. At multivariate analysis factors negatively influencing survival were a disease-free interval (DFI) of less than 24 months and recurrence after pulmonary metastasectomy. Conclusions: Pulmonary resection for metastatic gynecologic cancer is feasible and effective; adequate selection of patients is mandatory to achieve satisfactory results and long-term survival.

Background Vena cava anomalies are a rare group of anatomical variations due to an incorrect development of the superior or inferior vena cava during fetal life. They generally show no clinical relevance and the diagnosis is done due to the association with congenital heart diseases in most of cases. However, preoperative identification of these anomalies is mandatory for surgeons to proper surgical planning. If not recognized, lethal complications may occur, as already reported in literature. Case presentation We report a case series of three different unidentified vena cava anomalies in patients undergoing lung resection. These unrecognized anomalies led to minor complications in two cases and required an accurate intraoperative evaluation in another. A careful retrospective evaluation of preoperative radiological images showed the anomalies. Conclusions A careful evaluation of the vena cava anatomy at pre-operative imaging is mandatory for thoracic surgeons to properly plan the surgery and avoid complications.

La Strategic Research and Innovation Agenda - Italia (SRIA It) redatta dalla piattaforma tecnologica italiana per l’aeronautica (ACARE Italia) considerando peculiarità, esigenze e priorità nazionali - illustra obiettivi e roadmap tecnologica condivisi dai vari attori nazionali fornendo le linee di orientamento per le attività R-ST nonché un utile riferimento nella definizione delle strategie di investimento nazionale per il settore dell’Aeronautica e piu’ in generale del Trasporto Aereo, includendo anche i sistemi per missioni speciali civili e gli aspetti duali.

The Strategic Research and Innovation Agenda - Italia (SRIA It) - prepared by the Italian technology platform for aeronautics (ACARE Italia) considering national peculiarities, needs and priorities - illustrates objectives and technology roadmap shared by the various national actors providing at the same time guidelines for the R-D activities as well as a useful reference in the definition of national investment strategies for the Aeronautics sector and more in general for the Air Transport sector, also including systems for civilian special missions as well as dual aspects.

La Strategic Research and Innovation Agenda - Italia (SRIA It) - redatta dalla piattaforma tecnologica italiana per l’aeronautica (ACARE Italia) considerando peculiarità, esigenze e priorità nazionali - illustra obiettivi e roadmap tecnologica condivisi dai vari attori nazionali fornendo le linee di orientamento per le attività R-ST nonché un utile riferimento nella definizione delle strategie di investimento nazionale per il settore dell’Aeronautica e piu’ in generale del Trasporto Aereo, includendo anche i sistemi per missioni speciali civili e gli aspetti duali.

Resection and reconstruction of the pulmonary artery (PA), whether associated or not to a sleeve resection of the bronchus, allows complete resection of centrally located lung cancer, thus avoiding pneumonectomy. Despite initial concern related to technical difficulties, perioperative management and long term survival, recent studies showed continuous enhancement of the surgical technique and reconstruction materials, reduction of the complication rate and improvement in the survival. This allowed this procedure to gain widespread acceptance in the treatment of lung cancer.

Electrical or chemical stimulation of the inferior colliculus (IC) induces fear-like behaviors. More recently, consistent evidence has shown that electrical stimulation of the central nucleus of the IC supports Pavlovian conditioning and latent inhibition (LI). LI is characterized by retardation in conditioning and also by an impaired ability to ignore irrelevant stimuli, after a non-reinforced pre-exposure to the conditioned stimulus. LI has been proposed as a behavioral model of cognitive abnormalities seen in schizophrenia. The aim of the present study was to determine whether dopaminergic mechanisms in the IC are involved in LI of the conditioned emotional response (CER). To induce LI, a group of rats was pre-exposed (PE) to six tones in two sessions, while rats that were not pre-exposed (NPE) had two sessions without tone presentations. The conditioning consisted of two tone presentations to the animal, followed immediately by a foot shock. PE and NPE rats received IC microinjections of physiological saline, the dopaminergic agonist apomorphine (9.0 microg/0.5 microL/side), or the dopaminergic antagonist haloperidol (0.5 microg/0.5 microL/side) before both pre-exposure and conditioning. During the test, the PE rats that received saline or haloperidol had a lower suppression of the licking response compared to NPE rats that received vehicle or haloperidol, indicating that latent inhibition was induced. There was no significant difference in the suppression ratio in rats that received apomorphine injections into the IC, indicating reduced latent inhibition. These results suggest that dopamine-mediated mechanisms of the IC are involved in the development of LI.

The core of the nebula surrounding Eta Carinae has been observed with the VLT Adaptive Optics system NACO and with the interferometer VLTI/MIDI. Narrow-band images at 3.74 and 4.05 micron reveal the butterfly shaped dusty environment with an unprecedented spatial resolution. A void region around the central source was discovered, whose radius corresponds to the expected dust sublimation radius. Fringes have been obtained in the Mid-IR which reveal a correlated flux of about 100 Jy situated 0.3" south-east from the photocenter of the nebula at 8.7 which corresponds with the location of the star as seen in other wavelengths. This correlated flux is partly attributed to the central object and these observations provide an upper limit for the SED of the central source from 2.2 micron to 13.5 micron. Moreover, we have been able to spectrally disperse the signal from the nebula itself at PA=318 degree, i.e. in the direction of the bipolar nebula (310°) within the MIDI field of view of 3". A large amount of corundum (Al2O3) is discovered, peaking to the south-east from the star, whereas the dust content of the Weigelt blobs is more dominated by silicates.