The novel Rub+Soak B technique was the most effective and reasonable combination technique wherein the sealing mechanism was supported by the physical properties of the fibrin sealant components.

Adenovirus-mediated human interleukin 10 gene transfer in vivo into lung isografts ameliorates subsequent ischemia-reperfusion injury. This results in improved graft gas exchange, reduced neutrophil sequestration, and down-regulation of graft inducible nitric oxide synthase mRNA expression.

Lipid-mediated ex vivo viral IL10 gene transfer into rat lung allografts improved graft gas exchange, reduced histologic rejection scores, downregulated graft interleukin 2 mRNA expression, and reduced exhaled nitric oxide levels by postoperative day 5. These results suggest a therapeutic potential of graft viral IL10 gene transfer as an effective immunosuppressive strategy against lung allograft rejection.

No abstract

Pulmonary aspergillomas usually occur in pre-existing lung cavities exhibiting local immunodeficiency. As pulmonary aspergillomas only partially touch the walls of the cavities containing them, they rarely come into contact with the bloodstream, which makes it difficult for antifungal agents to reach them. Although surgical treatment is the optimal strategy for curing the condition, most patients also have pulmonary complications such as tuberculosis and pulmonary fibrosis, which makes this strategy difficult. A 72-year-old male patient complained of recurrent hemoptysis and dyspnea, and a chest X-ray and CT scan demonstrated the existence of a fungus ball in a pulmonary cavity exhibiting fibrosis. Although an examination of the patient's sputum was inconclusive, his increased 1-3-beta-D-glucan level and Aspergillus galactomannan antigen index were suggestive of pulmonary aspergilloma. Since the systemic administration of voriconazole for two months followed by itraconazole for one month was ineffective and surgical treatment was not possible due to the patient's poor respiratory function, liposomal amphotericin B was transbronchially administered directly into the aspergilloma. The patient underwent fiberoptic bronchoscopy, and a yellow fungus ball was observed in the cavity connecting to the right B2bi-beta, a biopsy sample of which was found to contain Aspergillus fumigatus. Nine transbronchial administrations of liposomal amphotericin B were conducted using a transbronchial aspiration cytology needle, which resulted in the aspergilloma disappearing by seven and a half months after the first treatment. This strategy could be suitable for aspergilloma patients with complications because it is safe and rarely causes further complications.

No abstract

A 77-year-old male with a long-standing history of smoking and working in mines was referred to our department for the evaluation of an enlarging subpleural mass in the right upper lobe. Both transbronchial and computed tomography-guided biopsies of the mass were non-diagnostic. A partial resection of the right S2 mass under video-assisted thoracic surgery (VATS) confirmed the diagnosis of primary non-small cell lung cancer. VATS right upper lobectomy (ND2a) was then performed for complete resection. Histological examination revealed that the mass composed of adenocarcinoma and the dilated bronchioles contained Aspergillus, the fungal component. Here we report a rare case of non-small cell lung cancer coexisting with pulmonary aspergillosis. The morphologic coexistence pattern of the two pathologies was believed to be the colonization of saprophytic Aspergillus in the bullous air spaces, obstructed by or contained within the tumor, according to the progression of the lung cancer.

The objectives of this study were to devise a new image processing technique to reconstruct dynamic three-dimensional (3D) virtual mediastinoscopic images on the basis of positron-emission tomography/computed tomography (PET/CT) datasets, and to examine the clinical utility of this technique for preoperative simulation of and intraoperative guidance during mediastinoscopic nodal biopsy. Of 54 patients with suspected or proven lung cancer (LC) who underwent mediastinoscopy between January 2005 and December 2007, 37 also underwent preoperative PET/CT. Of these 37 patients, we tested our image processing protocol in 15 consecutive patients with significant mediastinal uptake of fluorodeoxyglucose (FDG). We reconstructed 3D virtual mediastinoscopy movies in two mutually complementary demonstration modes--the tracheobronchial- and vessel-modes--with accurate representation of actual mediastinoscopic procedures. The benefit of these virtual imaging was evaluated with regard to their utility in mediastinoscopic nodal biopsy. Our new technique enabled better understanding of the spatial interrelationship between FDG-avid nodes and mediastinal structures. It facilitated more accurate and safer nodal biopsy under virtual guidance. In conclusion, we showed the feasibility of our virtual mediastinoscopic technique, which may improve the procedural safety and diagnostic accuracy of mediastinoscopic nodal biopsy and nodal staging in LC.