OBJECTIVE:This study evaluated the performance of lungs that were preserved with different solutions (Celsior, Perfadex or saline) in an ex vivo rat lung perfusion system.METHODS:Sixty Wistar rats were anesthetized, anticoagulated and randomized into three groups (n = 20). The rats were subjected to antegrade perfusion via the pulmonary artery with Perfadex, Celsior, or saline, followed by 6 or 12 hours of ischemia (4°C, n = 10 in each group). Respiratory mechanics, gas exchange and hemodynamics were measured at 10-minute intervals during the reperfusion of heart-lung blocks in an ex vivo system (IL2-Isolated Perfused Rat or Guinea Pig Lung System, Harvard Apparatus, Holliston, Massachusetts, USA; Hugo Sachs Elektronik, Germany) for 60 minutes. The lungs were prepared for histopathology and evaluated for edema following reperfusion. Group comparisons were performed using ANOVA and the Kruskal-Wallis test with a 5% level of significance.RESULTS:Gas exchange was not significantly different between lungs perfused with either Perfadex or Celsior at the same ischemic times, but it was very low in lungs that were preserved with saline. Airway resistance was greater in the lungs that were preserved for 12 hours. Celsior lungs that were preserved for 6 and 12 hours exhibited lower airway resistance (p = 0.01) compared to Perfadex lungs. Pulmonary artery pressure was not different between the groups, and no significant differences in histopathology and apoptosis were observed between the groups.CONCLUSIONS:Lungs that were preserved with Celsior or Perfadex exhibited similar gas exchange and histopathological findings. Airway resistance was slightly lower in the Celsior-preserved lungs compared with the Perfadex-preserved lungs.
The bronchogenic cyst is a common congenital malformation, generally located in the mediastinum; however, it can develop in other areas, such as the diaphragm. A rare case of intradiaphragmatic bronchogenic cyst is described here, discovered in a 32 year-old patient, who experienced thoracic pain and dyspnea following thoracic trauma. The pre-operative exams were compatible with left diaphragmatic hernia. The patient was submitted to a left post-lateral thoracotomy with the operative discovery of a cystic lesion enveloped by the diaphragm with mucinous content, and a partial resection of the diaphragm was performed. The histological findings of the operated portion revealed ciliated cylindrical epithelium, compatible with bronchogenic cysts. The post-operative outcome was excellent
O schwannoma benigno é um dos tumores mais comuns do mediastino posterior, sendo que durante o seu crescimento pode haver envolvimento do canal medular em forma de ampulheta e, mais raramente, isso pode ocorrer na árvore traqueobrônquica. É relatado um caso de uma mulher de 45 anos, portadora de schwannoma benigno de mediastino posterior, com padrão de desenvolvimento em ampulheta para a parede póstero-lateral direita da traquéia. O tratamento foi realizado por meio da ressecção endoscópica da porção intratraqueal e a tumoração mediastinal foi ressecada por toracotomia. Oito meses após o procedimento não foi evidenciada recidiva da lesão.
Claude Bernard-Horner syndrome presents various etiologies and occurs as the direct result of interrupted nerve signaling at any point along the nerve trajectory, be it intrathoracic or extrathoracic. Herein, we report a case of Claude BernardHorner syndrome caused by loculated pleural empyema located in the paravertebral region of the upper third of the right hemithorax. The patient was submitted to thoracotomy in order to drain the infected fluids. The end result was satisfactory, including resolution of the infection, pulmonary expansion, and remission of the syndrome.
A aspiração de corpo estranho é uma emergência médica potencialmente fatal, na qual os pacientes podem apresentar uma sintomatologia variada. É crucial intervir prontamente para aliviar a obstrução, uma vez que a eliminação espontânea do corpo estranho é rara e pode levar a complicações. O caso descrito envolve uma paciente que expeliu espontaneamente um osso de galinha que estava alojado cronicamente em brônquio fonte. Em adultos, a ocorrência é mais comum em homens e idosos, particularmente no brônquio direito. O tratamento envolve a remoção do corpo estranho por meio de intervenções como estimulação da tosse, golpes nas costas e impulsos abdominais. Geralmente, a broncoscopia flexível é eficaz, mas em casos específicos, a broncoscopia rígida pode ser preferida.
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