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The application of chemical hydrides (e.g. ammonia borane) and amide-based hydrogen storage materials would benefit from an effective means to remove ammonia, which is an impurity that is detrimental to the performance of a PEM fuel cell. One option is to adsorb ammonia on a sorbent with high capacity that would also be regenerable. Such a sorbent was developed by impregnating super activated carbon with metal chlorides (MgCl2, ZnCl2, MnCl2). The sorbent was characterized through static and dynamic adsorption experiments. It was shown to have a good cyclic stability. The filter weight, volume and pressure drop appears reasonable for an onboard vehicle application when it would be replaced/regenerated every 1800 miles, similar to an oil change.

Background: Perioperative atrial tachyarrhythmias (POAT) are the commonest arrhythmia after major lung resections. To date the relationship between POAT and CPET parameters were never tested after major thoracic surgery. Aim: To assess the association between CPET data and postoperative complications with particular focus on POAT. Methods: 48 consecutive patients undergoing major lung resection from Jan to Dec 2013 were assessed by pre-operative spirometry, arterial blood gas analysis, DLCO, CPET on cycle ergometer, ECG and echocardiogram. Cardiologic and respiratory complications were recorded and matched with functional parameters and to identify any potential risk factor. Results: Overall morbidity, POAT, atrial fibrillation (AF) and respiratory failure incidences were 18 (37.5%), 10 (20.8%), 5 (12.8%) and 9 (18%) respectively. The followed associations were found: older age (p=0.048), steeper Ve/VCO2 slope (p=0.002) and lower Maximum Heart Rate (MRH) (p=0.011) with POAT. Regression analysis indicated higher Ve/VCO2 (p=0.011; HR=1.39[CI95%:1.07-1.69],) and lower FC max (p=0.022; HR=1.06[CI95%:1.01-1.11],) as independent risk factors for POAT. AF was associated with age (p=0.037), lower VO2 max ml/Kg/min %pred (p=0.02), Ve/VCO2 slope (p=0.01), MHR (p=0.001); Pulmonary artery pressure (p=0.016); VO2 max ml/Kg/min %pred (p=0.011; HR=1.09[CI95%:1.02-1.16],) and lower MHR (p=0.048;HR=1.07[CI95%:1.00-1.15]) predict the risk of AF. Conclusions: VE/VCO2, MHR, VO2 max ml/Kg/min %pred are objective good predictor of POAT and AF and should be helpful to select patients for prophylactic therapy.

Bronchial fistula is one of the most serious complications after pulmonary resection. It presents a challenge in terms of treatment, with a high risk of perioperative mortality. We describe a patient who underwent a right upper lobectomy and systematic hilar-mediastinal lymphadenectomy for lung adenocarcinoma complicated by 2 bronchopleural fistulas. The lesions were sited at the upper lobar stump and the pars membranacea of the intermediate bronchus. The patient was successfully treated by placement of an endobronchial prosthesis (initially a self-expanding prosthesis and subsequently, a Dumon prosthesis) and a pleural chest drain, to avoid a potential right pneumonectomy.

The congenital thymic cysts are rare. They have a congenital origin and they are benign. The differential diagnosis of acquired cysts, cystic thymoma and thymic malignancies in cystic degeneration can be particularly difficult. Rarely, they assume clinical relevance for the appearance of symptoms of compression, more typical of malignant lesions, and the association with thymoma was reported in very few cases in literature. For all these features, treatment strategy remains controversial and in particular surgical approach. We report a case of a huge symptomatic congenital thymic cyst, surgically removed with histological finding of microscopic thymoma.

OBJECTIVES: A retrospective database was developed by the European Society of Thoracic Surgeons, collecting patients submitted to surgery for thymic tumours to analyse clinico-pathological prognostic predictors. METHODS: A total of 2151 incident cases from 35 institutions were collected from 1990 to 2010. Clinical-pathological characteristics were analysed, including age, gender, associated myasthenia gravis stage (Masaoka), World Health Organization histology, type of thymic tumour [thymoma, thymic carcinoma (TC), neuroendocrine thymic tumour (NETT)], type of resection (complete/incomplete), tumour size, adjuvant therapy and recurrence. Primary outcome was overall survival (OS); secondary outcomes were the proportion of incomplete resections, disease-free survival and the cumulative incidence of recurrence (CIR). RESULTS: A total of 2030 patients were analysed for OS (1798 thymomas, 191 TCs and 41 NETTs). Ten-year OS was 0.73 (95% confidence interval 0.69–0.75). Complete resection (R0) was achieved in 88% of the patients. Ten-year CIR was 0.12 (0.10–0.15). Predictors of shorter OS were increased age (P

The aim of the study is to evaluate the efficacy and safety of a three-drug chemotherapy regimen including gemcitabine, carboplatin, and paclitaxel as induction therapy in clinical stage III non-small cell lung cancer (NSCLC). Patients aged 18-75 years, ECOG PS 0-1, with unresectable clinical stage IIIA or IIIB NSCLC suitable for definitive radiation treatment, were treated in a phase II study with i.v. carboplatin AUC 5 and i.v., paclitaxel 175 mg/m(2) on day 1, and i.v. gemcitabine 800 mg/m(2) on days 1 and 8, every 3 weeks for 3 cycles, as previously assessed in a dose-finding study. Primary end point was overall response rate (ORR). Secondary end points included: toxicity, progression-free survival (PFS), resection rate, and overall survival (OS). Out of the 60 enrolled patients, 49 were males and 11 females, 31 patients had stage IIIA and 29 stage IIIB NSCLC. Forty-four partial responses and one complete response were observed, for an ORR of 75 %. The most frequent G3-G4 toxicity included: neutropenia (in 23 % of cases), hypertransaminasemia (12 %), and diarrhea (5 %). With a median follow-up of 15 months (range 2-72), median PFS was 10.5 months (95 % CI 9.9-11.4) and median OS was 21.1 months (95 % CI 19.7-22.8). Fourteen stage IIIA patients underwent surgery, for a resection rate of 45 %. A median PFS of 17.8 months (95 % CI 16.2-19.7) and a median OS of 25.5 months (95 % CI 23.0-28.4) were observed in stage IIIA patients. The three-drug chemotherapy regimen, at the employed dose, demonstrated a considerable disease response and resection rate, with acceptable toxicity.

Synchronous or metachronous brain metastases (BMs) occur in about 33% of patients affected by non-small-cell lung cancer (NSCLC). To date, no reliable biological marker is able to identify patients who will develop BMs. In the present study, using a quantitative double-labeling immunofluorescence analysis, we evaluated the expression of chemokine CXCL12 and its receptor, CXCR4, in primary NSCLC histological specimens of patients with and without BMs. The immunoreactivity of CXCL12 and CXCR4 was significantly higher in NSCLC samples of patients with BMs. We performed Receiver Operating Characteristics (ROC) analysis in order to define optimal cut-off values for CXCL12 and CXCR4 immunoreactivity that could discriminate between NSCLC patients without and with BMs. ROC curves showed a good diagnostic accuracy and adequate predictive power for both CXCL12 and CXCR4. These findings suggest a possible role for the CXCL12/CXCR4 axis in the metastatic evolution of NSCLC, and its potential use as prognostic markers and drug targets.

7063 Background: The addition of gemcitabine (G) to doublet chemotherapy with carboplatin (C) and paclitaxel (P) has demonstrated to improve clinical outcome of advanced stage IIIB and IV NSCLC in ...