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Upper lobectomy might have a volume reduction effect.

We examined the effect of a simple intraoperative intrathoracic hyperthermotherapy (IIH) and a simple intraoperative intrathoracic hyperthermo-chemotherapy (IIHC) on malignant pleural effusion and/or dissemination with primary non-small lung cancer. This study included 19 patients who had malignant pleural effusion and/or dissemination recognized for the first time at the time of surgery. We performed surgical procedures on the primary lesions and then the additional therapies followed. Seven patients received IIH (group A), five patients underwent IIHC (group B), and seven patients did not have any additional therapy (group C). There was no death during the follow-up period (9-35 months) in the group A. The median survival time was 41 months in the group B and 25 months in the group C. The group A was completely free of pleural effusion and one patient in the group B suffered from pleural effusion 26 months after surgery, although the median term of freedom from pleural effusion was three months in the group C. In patients with malignant pleural effusion and/or dissemination with primary non-small lung cancer, not only IIHC but also IIH might be beneficial in the prevention of pleural effusion instead of the improvement in prognosis.

We aimed at providing the first in vitro and in vivo proof-of-concept for a novel tracheal tissue engineering technology. We hypothesized that bioartificial trachea (BT) could be generated from fibroblast and collagen hydrogels, mechanically supported by osteogenically-induced mesenchymal stem cells (MSC) in ring-shaped 3D-hydrogel cultures, and applied in an experimental model of rat trachea injury. Tube-shaped tissue was constructed from mixtures of rat fibroblasts and collagen in custom-made casting molds. The tissue was characterized histologically and mechanically. Ring-shaped tissue was constructed from mixtures of rat MSCs and collagen and fused to the tissue-engineered tubes to function as reinforcement. Stiffness of the biological reinforcement was enhanced by induction of osteogeneic differentiation in MSCs. Osteogenic differentiation was evaluated by assessment of osteocalcin (OC) secretion, quantification of calcium (Ca) deposit, and mechanical testing. Finally, BT was implanted to bridge a surgically-induced tracheal defect. A three-layer tubular tissue structure composed of an interconnected network of fibroblasts was constructed. Tissue collapse was prevented by the placement of MSC-containing ring-shaped tissue reinforcement around the tubular constructs. Osteogenic induction resulted in high OC secretion, high Ca deposit, and enhanced construct stiffness. Ultimately, when BT was implanted, recipient rats were able to breathe spontaneously.

The aim of this retrospective study was to evaluate the influence of the site of lobectomy and the presence of chronic obstructive pulmonary disease (COPD) on pulmonary function at different postoperative periods. The patients were divided into groups of COPD and non-COPD patients, and the differences between observed and predicted postoperative values of pulmonary function at different evaluation times according to the resected lobe were assessed. The observed postoperative percentage change in FEV(1) (opo%DeltaFEV(1)) - predicted postoperative percentage change in FEV(1) (ppo%DeltaFEV(1)) one month and six months after right upper lobectomy or left upper lobectomy in COPD patients was of significantly higher positive value than in non-COPD patients. In non-COPD patients, opo%DeltaFEV(1) - ppo%DeltaFEV(1) one month and six months after surgery was of significantly higher negative value in those who had right upper lobectomy than in those who had right lower lobectomy or left lower lobectomy (P<0.05). COPD may strongly influence pulmonary function at early- and late-terms after upper lobectomy. In non-COPD patients, the site of lobectomy may strongly influence pulmonary function at early- and late-terms after surgery.

The aim of the present study was to evaluate the effects of the REG Iα and REG Iβ genes on lung cancer cell lines, and thereafter, the expression of REG family genes (REG Iα, REG Iβ, REG III, HIP/PAP and REG IV) in lung cancer in relation to patient prognosis was evaluated. Lung adenocarcinoma (AD) and squamous cell carcinoma (SCC) cell lines expressing REG Iα or REG Iβ (HLC-1 REG Iα/Iβ and EBC-1 REG Iα/Iβ) were established, and cell number, cell invasive activity, and anchorage-independent cell growth were compared with these variables in the control cells. The expression levels of REG family genes were evaluated by real-time RT-PCR in surgically resected lung cancers, and disease-specific survival (DSS) curves were generated. The HLC-1 REG Iα/Iβ cell line showed significant increases in cell number and anchorage-independent cell growth compared with the control cells. EBC-1 REG Iα/Iβ cells showed significant increases in cell invasive activity and anchorage-independent cell growth as compared with the control cells. Except for the REG Iβ gene, expression of other REG family genes was observed in the surgically resected samples; however, DSS was significantly worse only in stage I patients who were positive for REG Iα expression than in patients who were negative for REG Iα expression. The effects of REG Iα on AD and SCC cells were different in the in vitro study, and a correlation between REG Iα expression and patient prognosis was noted in the in vivo study. Therefore, overexpression of REG Iα is a risk factor for poor prognosis caused by discrete mechanisms in AD and SCC patients.

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