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Sukkar B, Oktay L, Sahaboglu A, Moayedi A, Zenouri S, Al-Maghout T, Cantó A, Miranda M, Durdagi S, Hosseinzadeh Z. Inhibition of altered Orai1 channels in Müller cells protects photoreceptors in retinal degeneration. Glia 2023; 71:2511-2526. [PMID: 37533369 DOI: 10.1002/glia.24429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 08/04/2023]
Abstract
The expressions of ion channels by Müller glial cells (MGCs) may change in response to various retinal pathophysiological conditions. There remains a gap in our understanding of MGCs' responses to photoreceptor degeneration towards finding therapies. The study explores how an inhibition of store-operated Ca2+ entry (SOCE) and its major component, Orai1 channel, in MGCs protects photoreceptors from degeneration. The study revealed increased Orai1 expression in the MGCs of retinal degeneration 10 (rd10) mice. Enhanced expression of oxidative stress markers was confirmed as a crucial pathological mechanism in rd10 retina. Inducing oxidative stress in rat MGCs resulted in increasing SOCE and Ca2+ release-activated Ca2+ (CRAC) currents. SOCE inhibition by 2-Aminoethoxydiphenyl borate (2-APB) protected photoreceptors in degenerated retinas. Finally, molecular simulations proved the structural and dynamical features of 2-APB to the target structure Orai1. Our results provide new insights into the physiology of MGCs regarding retinal degeneration and shed a light on SOCE and Orai1 as new therapeutic targets.
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Affiliation(s)
- Basma Sukkar
- Paul Flechsig Institute, Centre of Neuropathology and Brain Research, University of Leipzig, Leipzig, Germany
| | - Lalehan Oktay
- Computational Biology and Molecular Simulations Laboratory, Department of Biophysics, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Ayse Sahaboglu
- Institute for Ophthalmic Research, Centre for Ophthalmology, Eberhard Karls University, Tübingen, Germany
| | - Aylin Moayedi
- Paul Flechsig Institute, Centre of Neuropathology and Brain Research, University of Leipzig, Leipzig, Germany
| | - Shima Zenouri
- Paul Flechsig Institute, Centre of Neuropathology and Brain Research, University of Leipzig, Leipzig, Germany
| | - Tamer Al-Maghout
- Department of Cardiology and Vascular Medicine and Physiology, University of Tübingen, Tübingen, Germany
| | - Antolin Cantó
- Departamento Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - María Miranda
- Departamento Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Serdar Durdagi
- Computational Biology and Molecular Simulations Laboratory, Department of Biophysics, School of Medicine, Bahcesehir University, Istanbul, Turkey
- Molecular Therapy Laboratory, School of Pharmacy, Bahcesehir University, Istanbul, Turkey
| | - Zohreh Hosseinzadeh
- Paul Flechsig Institute, Centre of Neuropathology and Brain Research, University of Leipzig, Leipzig, Germany
- Department of Ophthalmology and Eye Hospital, University of Leipzig, Leipzig, Germany
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2
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Martínez-González J, Fernández-Carbonell Á, Cantó A, Gimeno-Hernández R, Almansa I, Bosch-Morell F, Miranda M, Olivar T. Sequences of Alterations in Inflammation and Autophagy Processes in Rd1 Mice. Biomolecules 2023; 13:1277. [PMID: 37759678 PMCID: PMC10527025 DOI: 10.3390/biom13091277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: the aim of this work was to study microglia and autophagy alterations in a one retinitis pigmentosa (RP) model at different stages of the disease (when rods are dying and later, when there are almost no rods, and cones are the cells that die. (2) Methods: rd1 mice were used and retinas obtained at postnatal days (PN) 11, 17, 28, 35, and 42. Iba1 (ionized calcium-binding adapter molecule 1) was the protein selected to study microglial changes. The macroautophagy markers Beclin-1, Atg5, Atg7, microtubule-associated protein light chain 3 (LC3), and lysosomal-associated membrane protein 2 (LAMP2) (involved in chaperone-mediated autophagy (CMA)) were determined. (3) Results: the expression of Iba1 was increased in rd1 retinas compared to the control group at PN17 (after the period of maximum rod death), PN28 (at the beginning of the period of cone death), and PN42. The number of activated (ameboid) microglial cells increased in the early ages of the retinal degeneration and the deactivated forms (branched cells) in more advanced ages. The macroautophagy markers Atg5 at PN11, Atg7 and LC3II at PN17, and Atg7 again at PN28 were decreased in rd1 retinas. At PN35 and PN42, the results reveal alterations in LAMP2A, a marker of CMA in the retina of rd1 mice. (4) Conclusions: we can conclude that during the early phases of retinal degeneration in the rd1 mouse, there is an alteration in microglia and a decrease in the macroautophagy cycle. Subsequently, the CMA is decreased and later on appears activated as a compensatory mechanism.
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Affiliation(s)
| | | | | | | | | | | | | | - Teresa Olivar
- Department of Biomedical Sciences, Faculty of Health Sciences, Institute of Biomedical Sciences, Cardenal Herrera-CEU University, CEU Universities, 46115 Valencia, Spain; (J.M.-G.); (Á.F.-C.); (A.C.); (R.G.-H.); (I.A.); (F.B.-M.); (M.M.)
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3
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Sanz MM, Cantó A, Olivar T, López‐Pedrajas R, Martínez‐González J, Hernández‐Rabaza V, Almansa I. Administration of dutasteride in animal models of retinitis pigmentosa. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.0691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Affiliation(s)
- María Miranda Sanz
- Departamento de Ciencias Biomédicas Universidad CEU Cardenal Herrera Alfara del Patriarca Spain
| | - Antolin Cantó
- Departamento de Ciencias Biomédicas Universidad CEU Cardenal Herrera Alfara del Patriarca Spain
| | - Teresa Olivar
- Departamento de Ciencias Biomédicas Universidad CEU Cardenal Herrera Alfara del Patriarca Spain
| | - Rosa López‐Pedrajas
- Departamento de Ciencias Biomédicas Universidad CEU Cardenal Herrera Alfara del Patriarca Spain
| | | | | | - Inmaculada Almansa
- Departamento de Ciencias Biomédicas Universidad CEU Cardenal Herrera Alfara del Patriarca Spain
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4
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Gimeno-Hernández R, Cantó A, Fernández-Carbonell A, Olivar T, Hernández-Rabaza V, Almansa I, Miranda M. Thioredoxin Delays Photoreceptor Degeneration, Oxidative and Inflammation Alterations in Retinitis Pigmentosa. Front Pharmacol 2021; 11:590572. [PMID: 33424600 PMCID: PMC7785808 DOI: 10.3389/fphar.2020.590572] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 11/03/2020] [Indexed: 01/02/2023] Open
Abstract
Retinitis pigmentosa (RP) is an inherited ocular disorder with no effective treatment. RP onset and progression trigger a cascade of retinal disorders that lead to the death of photoreceptors. After photoreceptors death, neuronal, glial and vascular remodeling can be observed in the retina. The purpose of this study was to study if thioredoxin (TRX) administration is able to decrease photoreceptor death in an animal model of RP (rd1 mouse), but also if it is able to modulate the retinal oxidative stress, glial and vascular changes that can be observed as the disease progresses. Wild type and rd1 mice received several doses of TRX. After treatment, animals were euthanized at postnatals days 11, 17, or 28. Glutathione (GSH) and other thiol compounds were determined by high performance liquid chromatography (HPLC). Glial fibrilary acidic protein (GFAP) and anti-ionized calcium binding adaptor molecule 1 (Iba1) were studied by immunohistochemistry. Vascular endothelial growth factor (VEGF) and hepatic growth factor (HGF) expression were determined by western blot. TRX administration significantly diminished cell death in rd1 mouse retinas and increased GSH retinal concentrations at postnatal day 11 (PN11). TRX was also able to reverse glial alterations at PN11 and PN17. No alterations were observed in retinal VEGF and HGF expression in rd1 mice. In conclusion, TRX treatment decreases photoreceptor death in the first stages of RP and this protective effect may be due in part to the GSH system activation and to a partially decrease in inflammation.
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Affiliation(s)
- Roberto Gimeno-Hernández
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Antolin Cantó
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Angel Fernández-Carbonell
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Teresa Olivar
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Vicente Hernández-Rabaza
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Inmaculada Almansa
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - María Miranda
- Departamento Ciencias Biomédicas, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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5
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Cantó A, Olivar T, Romero FJ, Miranda M. Nitrosative Stress in Retinal Pathologies: Review. Antioxidants (Basel) 2019; 8:antiox8110543. [PMID: 31717957 PMCID: PMC6912788 DOI: 10.3390/antiox8110543] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 10/30/2019] [Accepted: 11/06/2019] [Indexed: 12/20/2022] Open
Abstract
Nitric oxide (NO) is a gas molecule with diverse physiological and cellular functions. In the eye, NO is used to maintain normal visual function as it is involved in photoreceptor light transduction. In addition, NO acts as a rapid vascular endothelial relaxant, is involved in the control of retinal blood flow under basal conditions and mediates the vasodilator responses of different substances such as acetylcholine, bradykinin, histamine, substance P or insulin. However, the retina is rich in polyunsaturated lipid membranes and is sensitive to the action of reactive oxygen and nitrogen species. Products generated from NO (i.e., dinitrogen trioxide (N2O3) and peroxynitrite) have great oxidative damaging effects. Oxygen and nitrogen species can react with biomolecules (lipids, proteins and DNA), potentially leading to cell death, and this is particularly important in the retina. This review focuses on the role of NO in several ocular diseases, including diabetic retinopathy, retinitis pigmentosa, glaucoma or age-related macular degeneration (AMD).
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Affiliation(s)
- Antolin Cantó
- Departamento Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, 64315 Valencia, Spain; (A.C.); (T.O.)
| | - Teresa Olivar
- Departamento Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, 64315 Valencia, Spain; (A.C.); (T.O.)
| | - Francisco Javier Romero
- Departamento de Ciencias Biomédicas, Universidad Europea de Valencia, 46010 Valencia, Spain;
| | - María Miranda
- Departamento Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Cardenal Herrera-CEU, CEU Universities, 64315 Valencia, Spain; (A.C.); (T.O.)
- Correspondence: ; Tel.: +34-961369000
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6
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Juan G, Ramón M, Cantó A. Respuesta de los autores. Arch Bronconeumol 2005. [DOI: 10.1157/13078659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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7
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Canela M, Maestre J, Rodriguez-Paniagua M, Astudilo J, Borro J, Aguiló R, Torrres A, Cantó A, Padilla J, Molins L. PD-087 NATCH trial update. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80420-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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8
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Garrigós MC, Marín ML, Cantó A, Sánchez A. Determination of residual styrene monomer in polystyrene granules by gas chromatography–mass spectrometry. J Chromatogr A 2004; 1061:211-6. [PMID: 15641364 DOI: 10.1016/j.chroma.2004.10.102] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Polystyrene is widely used in formulations intended for children use. The main problem with this plastic is the residual styrene, which can migrate from the product, and therefore, be in contact with children. The acute toxicity of styrene is well known, raising the need of an efficient and fast method of analysis for this compound. Several extraction methods have been evaluated and compared for the determination of residual styrene monomer in polystyrene granules used in toys: supercritical fluid extraction (SFE), microwave-assisted extraction (MAE), Soxhlet extraction, headspace emission and dissolution-precipitation. The analyte was subsequently detected by gas chromatography (GC) with MS detection. The results indicated that the most efficient method was dissolution-precipitation giving even higher extraction efficiency than SFE. For validating the method, PS samples spiked with known quantities of styrene at three concentration levels were prepared to calculate the extraction recovery. The founded validation data proved the suitability of the proposed method.
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Affiliation(s)
- M C Garrigós
- Institute of Toys Technology (AIJU), Av Industria 23, 03440, Ibi (Alicante), Spain.
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9
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Granell M, Peña J, Ubeda J, Soriano J, Tatay J, Cantó A, Llorens J. [Anesthesiology alternatives for lobectomy with thoracotomy in a patient with allergy to multiple neuromuscular blockers]. Rev Esp Anestesiol Reanim 2003; 50:160-2. [PMID: 12708217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
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10
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Guijarro R, Cantó A. [The history of chest drainage]. Arch Bronconeumol 2002; 38:489-91. [PMID: 12372200 DOI: 10.1016/s0300-2896(02)75271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R Guijarro
- Servicio de Cirugía Torácica. Hospital General Universitario. Valencia. Spain.
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11
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Rech F, Garrigós MC, Marín ML, Cantó A, Jiménez A. Optimization of parameters for the supercritical fluid extraction in the determination of N-nitrosamines in rubbers. J Chromatogr A 2002; 963:419-26. [PMID: 12187998 DOI: 10.1016/s0021-9673(02)00549-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The study of the possibilities of supercritical fluid extraction (SFE) with N-nitrosamines in rubbers has been carried out. Home-made materials fortified with several N-nitrosamines were prepared in order to optimize the SFE parameters. A Plackett-Burman design was employed to evaluate the influence of those parameters to be controlled in SFE, such as pressure, temperature, static and dynamic time, restrictor temperature and volume of modifier while CO2 was used as the extraction fluid. An extra central composite design for the main factors (according to the previously obtained results) was also developed in order to refine the best supercritical conditions for the extraction of N-nitrosamines from rubbers. Gas chromatography with a nitrogen and phosphorus sensitive detector was used to achieve sensitivity and limits of detection for the concentrations expected in plastic materials. The proposed analytical method has shown to be useful in the determination of N-nitrosamines even for complex matrices.
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Affiliation(s)
- F Rech
- Analytical Chemistry Department, University of Alicante, Spain.
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12
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13
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Regueiro F, Arnau A, Cantó A. Cardiovascular repercussion of irresectable giant mediastinal schwannoma. J Cardiovasc Surg (Torino) 2001; 42:285-6. [PMID: 11292952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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14
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Regueiro F, Arnau A, Cantó A. Traumatic chylothorax after right pulmonary resection. Successful conservative management. Thorac Cardiovasc Surg 2000; 48:382. [PMID: 11145413 DOI: 10.1055/s-2000-8353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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15
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Cañizares MA, Arnau A, Fortea A, Zarzuela V, Martínez-Vallina P, Cantó A. [Hyoid fracture and traumatic subcutaneous cervical emphysema from an attempted hanging. Apropos a case]. Arch Bronconeumol 2000; 36:52-4. [PMID: 10726185 DOI: 10.1016/s0300-2896(15)30233-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We describe a patient with a history of psychiatric disorder who was brought to our hospital after attempted suicide by hanging. Severe subcutaneous facial, palpebral and cervical emphysema was present, with dysphonia, dysphagia and slight respiratory difficulty. Fiberoptic bronchoscopy revealed upper airway obstruction due to edema in an intact airway. Successive CAT scans gave evidence of hyoid fracture and laryngocele, in addition to the corresponding emphysema of the subcutaneous area and pneumomediastinum. Given the persistence of dysphagia, we ordered esophageal tests, which showed functional alteration of the upper esophageal sphincter. Suprasternal cervicotomy to drain the pneumomediastinum and laryngeal microsurgery to treat the laryngocele resolved the problem.
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Affiliation(s)
- M A Cañizares
- Servicio de Cirugía Torácica, Hospital General Universitario, Valencia
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16
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Regueiro F, Arnau A, Pérez D, Cañizares MA, Martínez P, Cantó A. [Pneumothorax as the clinical presentation of bronchogenic carcinoma. A report of 3 cases]. Arch Bronconeumol 2000; 36:55-7. [PMID: 10726186 DOI: 10.1016/s0300-2896(15)30234-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The association of pneumothorax and lung cancer is rare and diagnosis is complex in such cases. Clinical suspicion of cancer must be based on radiological findings and the existence of risk factors. We discuss the mechanisms involved in the development of pneumothorax in patients with lung cancer, the clinical significance of the association, and the recommended diagnostic approach and therapeutic guidelines.
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Affiliation(s)
- F Regueiro
- Servicio de Cirugía Torácica, Hospital General Universitario de Valencia
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17
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18
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Rosell R, Gómez-Codina J, Camps C, Javier Sánchez J, Maestre J, Padilla J, Cantó A, Abad A, Roig J. Preresectional chemotherapy in stage IIIA non-small-cell lung cancer: a 7-year assessment of a randomized controlled trial. Lung Cancer 1999; 26:7-14. [PMID: 10574676 DOI: 10.1016/s0169-5002(99)00045-8] [Citation(s) in RCA: 259] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In 1989, we began a multicenter study to evaluate the potential benefit of preoperative chemotherapy with cisplatin, ifosfamide and mitomycin over surgery alone in CT-visible N2 non-small-cell lung cancer. We present here a 7-year assessment of this randomized trial. Sixty patients were randomized to receive either surgery alone or three cycles of mitomycin 6 mg/m2, ifosfamide 3 g/m2 and cisplatin 50 mg/m2, given intravenously on day 1 of each cycle at 3-week intervals and followed by surgery. All patients received thoracic irradiation after surgery. The resected tumors were evaluated for the presence of K-ras gene point mutations. Treatment arms were well-balanced in characteristics such as gender, age, histology, and tumor size. Mediastinoscopy and/or mediastinotomy (Chamberlain procedure) with a biopsy was performed in all patients with N2 stage detected by CT scan of the chest (83% of the patients in the preresectional chemotherapy arm and 63% of those in the surgery arm). In eight of the 25 patients (32%) who had mediastinoscopy in the preresectional chemotherapy arm, the initially positive mediastinal lymph nodes were downstaged. For the 30 patients who received preresectional chemotherapy, overall median survival was 22 months (95% CI, 13.4 30.6). Of the 30 patients who received surgery alone, overall median survival was 10 months (95% CI, 7.4-12.6; P = 0.005 by the log rank test). Updated survival data reveals a plateau in the preresectional chemotherapy group, and this still significant long-term survival benefit prompts us to hypothesize that even with short-term preresectional chemotherapy, the natural history of still resectable CT-visible N2 non-small cell lung cancer is favorably altered. The results of our study mirror the long-term survival recently reported in the MD Anderson randomized study.
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Affiliation(s)
- R Rosell
- Medical Oncology Service, Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain.
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19
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Abstract
We review cases of thymic cell tumor treated between January 1991 and March 1998. Nineteen of the 23 cases studied involved thymoma. Eight (42%) were asymptomatic, 4 (21%) were associated with myasthenia gravis and 7 (37%) were symptomatic. The most common symptom was non-specific chest pain, reported by 4 (47%) patients with symptoms. Classifying the cases of thymoma by Masaoka's system, we found that 12 were cases of thymoma in stage I (63.2%), 4 in stage II (21.1%) and 3 in stage III (15.8%). No stage IV patients were treated. Treatment consisted of full exeresis of the tumor in 17 (89.5%) cases, partial resection in one case (5.2%) and biopsy of the tumor in one non-resectable, case. Adjuvant radiotherapy was applied in seven cases. Chemotherapy was not prescribed. With follow-up ranging from 9 to 96 months, half the patients survived 21 months after surgery. Among the surviving patients, mortality was nil at the end of the study. The results of microscopic, cytologic and blood analyses were of scarce value in differentiating between benign and malignant tumors, even though p53 and bcl2 antigen positivity and clinical stage have been related to poor prognosis in recent years.
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Affiliation(s)
- M A Cañizares
- Servicio de Cirugía Torácica, Hospital General Universitario, Valencia
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20
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Abstract
We report the results of a study performed in the thoracic surgery department of Hospital General Universitario of Valencia from October 1989 to December 1996. Of the 621 patients diagnosed of lung cancer during this period, 320 underwent the usual surgical excision, 18 were confirmed histologically as bronchial carcinoid tumors, indicating an incidence of 5.6% of all pulmonary neoplasms resected in our department. The symptoms most often reported were recurring infection (44.5%) and chest pain (33.3%). Only one patient presented carcinoid syndrome. The most common radiologic presentation was solitary pulmonary nodule (50%). The tumor was visible by fiberoptic bronchoscopy in 9 cases. Diagnosis was by bronchial biopsy in four cases. Confirmation was by immunohistochemical analysis of the specimen in all cases. Electron microscopy and immunohistochemical techniques using neuroendocrine panmarkers is considered fundamental for differentiating between neuroendocrine neoplasms and typical and atypical carcinoid tumors. Thirteen (72.2%) of the 18 patients studied were diagnosed of typical carcinoids and 5 (27.8%) of atypical carcinoids. Neuroendocrine marking showed neurospecific enolase in 15 patients and chromogranin positivity in 10.
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Affiliation(s)
- E Pareja
- Servicio de Cirugía Torácica, Hospital General Universitario de Valencia
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21
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García-Aguado R, Mateo EM, Tommasi-Rosso M, Grau F, Galbis J, Cantó A, Arnau A. Thoracic surgery and difficult intubation: another application of univent tube for one-lung ventilation. J Cardiothorac Vasc Anesth 1997; 11:925-6. [PMID: 9412903 DOI: 10.1016/s1053-0770(97)90153-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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22
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Arnau A, Martín E, Cantó A. [Costal chondrosarcoma. A report of 2 cases]. Arch Bronconeumol 1997; 33:478. [PMID: 9424267 DOI: 10.1016/s0300-2896(15)30553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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23
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Abstract
The results of the first three pulmonary reduction operations performed at our hospital for the palliative treatment of pulmonary emphysema are described. The upper third of the upper right lobe and part of the middle lobe were resected in two patients. An upper right lobectomy was performed on the third. Goretex coated autosutures were used and pleurosis was performed with talcum on the upper third of the hemithorax. Drains with -5 cmH2O suction were inserted. We emphasize the advance stage of disease of the three patients and the good outcomes observed in terms of survival, hospital stay and improvement in lung function and symptoms. We discuss the functional improvement resulting from lung reduction in cancer patients if the resected area is emphysematous.
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Affiliation(s)
- G Juan
- Servicio de Neumología, Hospital General Universitario de Valencia
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Cantó A, Guijarro R, Arnau A, Galbis J, Martorell M, García Aguado R. Videothoracoscopy in the diagnosis and treatment of malignant pleural mesothelioma with associated pleural effusions. Thorac Cardiovasc Surg 1997; 45:16-9. [PMID: 9089969 DOI: 10.1055/s-2007-1013677] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Between 1985 and 1994 46 of 662 patients examined by thoracoscopy for secondary malignant pleural effusion were diagnosed to have diffuse malignant pleural mesothelioma. Mean patient age was 59 years, with a male: female ratio of 5:1. The right hemithorax was more frequently involved than the left (55% versus 45%). Pleural fluid cytology revealed malignancy in 61.5% of cases. All patients were treated thoracoscopically by talc pleurodesis. Mean patients survival was 9.4 months. Survival after one, two, and 5 years was 37.5%, 12.5%, and 5%, respectively. The characteristics of mesothelioma and pleural effusion evident in thoracoscopy and their diagnostic relevance are discussed. We suggest talc instillation as the sole therapeutic maneuver in evolutioned cases, since the literature and our own experience indicate that survival is not significantly prolonged by more aggressive surgical approaches.
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Affiliation(s)
- A Cantó
- Department of Thoracic Surgery, Valencia University General Hospital, Spain
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25
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Cantó A, Arnau A, Galbis J, Martín E, Guijarro R, Fernández A, Martínez P, Martorell M, Pareja E, García-Aguado R, Rico G. [The so-called malignant pleural effusion: a new review of direct data obtained with diagnostic pleuroscopy]. Arch Bronconeumol 1996; 32:453-8. [PMID: 9064083 DOI: 10.1016/s0300-2896(15)30706-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
We analyze a series of 896 thoracoscopies for pleural effusion, of which 78% (662/896) were due to pleural carcinomatosis, primary or metastatic. Pleural malignancy was observed mainly, in the right hemithorax (65%), arising from tumors within the diaphragm. The likelihood of finding pleural metastasis in lung cancer was 77%. When the pleural effusion is slight (less than 500 ml) the likelihood falls to 22%. We therefore advise thoracoscopy in the former and thoracotomy in the latter. Blood-stained effusion continues to have the worst prognosis (84% stemming from metastasis) and signifies an advanced stage of pleural metastasis. The pleura parietal is involved in 69% of pleural carcinomatosis cases, and in 80% when the lower hemithorax or the area around breast or lung tumors are involved. The cytology yield was 45.9%, though always depending on extent of metastasis. When metastasis was slight, the likelihood of positive cytology was less (19%) and when metastasis was generalized throughout the entire pleura the likelihood increased to 73%. We found no reason to think that the cells in most pleural liquids are able to nest and form tumoral niches. The origin of such cell nests was rather found to be in shedding from the metastases themselves, from lung tumors or from carcinomatous lymphangitis by lymphatic obstruction. The diagnostic yield of thoracoscopy once again proved to be superior to that of pleural biopsy.
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Affiliation(s)
- A Cantó
- Servico de Cirugía Torácica, Hospital General Universitario, Valencia
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26
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García-Aguado R, Tommasi Rosso M, Granell M, Grau F, Cantó A, Arnau A. [Diagnostic thoracoscopy]. Rev Esp Anestesiol Reanim 1996; 43:298-9. [PMID: 9011904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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27
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Galbis JM, Fuster CA, Martín E, Guijarro J, Arnau A, Fernández-Centeno A, Villalba R, Villalba F, Cantó A. [Iatrogenic bilateral hydrothorax following the placement of a central catheter]. NUTR HOSP 1995; 10:234-6. [PMID: 7662762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
We present a case of bilateral hydrothorax after internal jugular vein catheterization. 60 hours after placing the catheter, the patient showed an abrupt picture of jugular ingurgitation, abolished vesicular breath sounds, and displaced cardiac tones. It was necessary to immediately drain one hemithorax to guarantee ventilation of the patient. The present article examines iatrogenicity derived from the placement of central catheters, and special attention is given to the need for post-insertion x-ray control.
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Affiliation(s)
- J M Galbis
- Servicio de Cirugía Torácica, Hospital General Universitario de Valencia, España
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28
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Cantó A, Arnau AF, Centeno A, Guijarro R, Galbis J, Martín E, Hernández L, Martorell M, García Aguado R. [Videothoracoscopy in staging of lung cancer]. Arch Bronconeumol 1995; 31:28-31. [PMID: 7881712 DOI: 10.1016/s0300-2896(15)30984-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We present a review of 108 cases of lung cancer in patients who, for a variety of reasons outlined in this report, underwent video assisted thoracoscopy prior to staging. Overall results of the procedure were positive in 94%. We report the usefulness of this tool for identifying adenopathic locations, for effecting biopsies of tumors that could not be typed by other means, for resecting peripheral nodules for screening purposes, and for making etiological diagnoses of accompanying pleural effusions. For diagnostic purposes, this procedure provides a better image than does conventional thoracoscopy, involves the participation of an endoscopy team and even calls for the presence of a pathologist. We consider video assisted thoracoscopy to be a highly effective tool for avoiding so-called pointless thoracotomies and for completing alternative treatments. Its cost effectiveness is indisputable, as are its low rates of morbidity and mortality.
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Affiliation(s)
- A Cantó
- Servicio de Cirugía Torácica, Hospital General Universitario, Valencia
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29
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Rosell R, Gómez-Codina J, Camps C, Maestre J, Padille J, Cantó A, Mate JL, Li S, Roig J, Olazábal A. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small-cell lung cancer. N Engl J Med 1994; 330:153-8. [PMID: 8043059 DOI: 10.1056/nejm199401203300301] [Citation(s) in RCA: 855] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The efficacy of surgery for patients with non-small-cell lung cancer is limited, although recent studies suggest that preoperative chemotherapy may improve survival. We conducted a randomized trial to examine the possible benefit of preoperative chemotherapy and surgery for the treatment of patients with non-small-cell lung cancer. METHODS We studied 60 patients (59 men and 1 woman) with stage IIIA non-small-cell lung cancer. The patients were randomly assigned to receive either surgery alone or three courses of chemotherapy (6 mg of mitomycin per square meter of body-surface area, 3 g of ifosfamide per square meter, and 50 mg of cisplatin per square meter) given intravenously at three-week intervals and followed by surgery. All patients received mediastinal radiation after surgery. The resected tumors were evaluated by means of K-ras oncogene analysis and flow cytometry. RESULTS The median period of survival was 26 months in the patients treated with chemotherapy plus surgery, as compared with 8 months in the patients treated with surgery alone (P < 0.001); the median period of disease-free survival was 20 months in the former group, as compared with 5 months in the latter (P < 0.001). The rate of recurrence was 56 percent in the group treated with chemotherapy plus surgery and 74 percent in the group treated with surgery alone. The prevalence of mutated K-ras oncogenes was 15 percent among the patients receiving preoperative chemotherapy and 42 percent among those treated with surgery alone (P = 0.05). Most of the patients treated with chemotherapy plus surgery had tumors that consisted of diploid cells, whereas the patients treated with surgery alone had tumors with aneuploid cells. CONCLUSIONS Preoperative chemotherapy increases the median survival in patients with non-small-cell lung cancer.
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Affiliation(s)
- R Rosell
- Department of Medical Oncology, University of Barcelona, Hospital de Badalona Germans Trias i Pujol, Spain
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30
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Cantó A, Guijarro R, Arnau A, Fernández-Centeno A, Císcar MA, Galbis J, García-Vilanova A. Thoracoscopic pericardial fenestration: diagnostic and therapeutic aspects. Thorax 1993; 48:1178-80. [PMID: 8296266 PMCID: PMC464916 DOI: 10.1136/thx.48.11.1178] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The cause of cardiac tamponade is only established in 50% of cases. This problem is most commonly treated by pericardiocentesis alone, pericardiotomy being reserved for cases of recurrence and pericardiectomy for those patients presenting with constrictive pericarditis. A series of 16 patients treated with pericardial fenestration via a thoracoscope is presented. Pericardial and pleural biopsies were performed, together with cytological and biochemical analysis of the pericardial and pleural fluid where present. This procedure established the aetiology of effusion in all cases. In malignant pericardial effusion bleomycin was used for pericardial sclerosis. This resulted in fewer recurrences than in those patients where sclerosis was not attempted (12.5% v 60%).
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Affiliation(s)
- A Cantó
- Thoracic Surgery Unit, Valencia University General Hospital, Spain
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31
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Cantó A, Guijarro R, Moya J, Ferrer G. Traqueobroncomegalia: nuevas consideraciones en el tratamiento quirúrgico. A propósito de un caso. Arch Bronconeumol 1992. [DOI: 10.1016/s0300-2896(15)31290-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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32
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Cantó A, Arnau A, Guijarro R, Fernández Centeno A, Martorell M. Actitud quirúrgica en el carcinoma broncopulmonar que se acompaña de un derrame pleural homolateral. Arch Bronconeumol 1992. [DOI: 10.1016/s0300-2896(15)31307-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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33
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Ferrando J, Martorell M, Cantó A. Paraganglioma pulmonar primario. Aportación de un caso. Arch Bronconeumol 1992. [DOI: 10.1016/s0300-2896(15)31333-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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34
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Cantó A, González A, Moya J, Arnau A, Saumench J, Morera R, Pujol R, Ferrer G, Carrizo S. La pleurodesis con talco en los derrames pleurales masivos y recidivantes de las cirrosis hepaticas. Arch Bronconeumol 1989. [DOI: 10.1016/s0300-2896(15)31688-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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35
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Cantó A, González A, Moya J, Pujol R, Arnau A, Ferrer G, Morera R, Saumench J, Hussein M. Aspectos macroscopicos de las metastasis pleurales de origen mamario observadas mediante la toracoscopia diagnostica. Arch Bronconeumol 1989. [DOI: 10.1016/s0300-2896(15)31700-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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36
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Saumench J, Escarrabill J, Padró L, Montañá J, Clariana A, Cantó A. Value of fiberoptic bronchoscopy and angiography for diagnosis of the bleeding site in hemoptysis. Ann Thorac Surg 1989; 48:272-4. [PMID: 2764618 DOI: 10.1016/0003-4975(89)90087-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
We evaluated 36 patients during active hemoptysis and compared the diagnostic yield of different procedures. Twenty-seven patients (75%) had one or more previous episodes of hemoptysis, most of which were not massive. Fiberoptic bronchoscopy was performed in 25 patients, and the bleeding site was identified in 17 (68%). The likelihood of localizing the bleeding site was significantly higher with early versus delayed fiberoptic bronchoscopy (91% versus 50%). Bronchial arteriography was performed in all 36 patients; positive arteriographies were observed in 20 cases (55.5%). Arteriography was positive in only 2 of the 8 cases in which fiberoptic bronchoscopy did not localize the site of bleeding. Bronchial artery embolization was successfully performed in 10 patients. However, the bleeding recurred within the first week after embolization in 2 patients, and 1 of them died.
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Affiliation(s)
- J Saumench
- Department of Thoracic Surgery, Hospital Príncipes de España, Barcelona, Spain
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37
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Murgoitio J, Cotillas J, Moya J, Bernat R, Cantó A. Estenosis laringo-traqueal por tiroiditis de riedel. Arch Bronconeumol 1989. [DOI: 10.1016/s0300-2896(15)31720-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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38
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Cantó A, Saumench J, Moya J, Hussein M, Pujol R, Mayoral M, Bernat R. Aspectos toracoscopicos en el mesotelioma pleural maligno difuso con derrame pleural. Arch Bronconeumol 1988. [DOI: 10.1016/s0300-2896(15)31796-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Cantó A, Rivas J, Moya J, Saumench J, Pac J, Morera R, Ferrer G. [Pleural effusion of malignant etiology. Thoracoscopic use of talc as an effective method of pleurodesis]. Med Clin (Barc) 1985; 84:806-8. [PMID: 4033261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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40
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Cantó A, Ferrer G, Romagosa V, Moya J, Bernat R. Lung cancer and pleural effusion. Clinical significance and study of pleural metastatic locations. Chest 1985; 87:649-52. [PMID: 2985340 DOI: 10.1378/chest.87.5.649] [Citation(s) in RCA: 75] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
We reviewed results of 78 diagnostic thoracoscopic examinations of patients with lung cancer and homolateral pleural effusion. The study stresses the main locations of pleural metastasis in cases of lung cancer and correlates these data with the pleural spread from extrathoracic primary neoplasms. Also pointed out is the operability of the present series and the different behavior in pleural metastatic spread according to the histologic type with correlation between gross appearance of the effusion and the cytology.
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41
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Montero Benzo R, Caffarena JM, Maeso J, Tomas FJ, Cantó A, Barber L, Gonsálbez J, Ramos F, Vicente JL, Tamarit V. [Use of pulmonary extracorporeal circulation in a case of refractary hypoxemia]. Rev Esp Anestesiol Reanim 1979; 26:456-66. [PMID: 545503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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42
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Benages A, París F, Ridocci MT, Tarazona V, Molina R, Mora F, Cantó A, Lloret M, Garrido G. Lesser curvature tubular gastroplasty with partial plication for gastroesophageal reflux: manometric and pH-metric postoperative studies. Ann Thorac Surg 1978; 26:574-80. [PMID: 37810 DOI: 10.1016/s0003-4975(10)62945-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Thirty-four patients with sliding hiatal hernia, gastroesophageal reflux, or both were treated by lesser curvature gastroplasty with partial gastric plication, using a surgical stapler. Before operation, esophageal manometric studies were performed in 33 patients and during the early postoperative period (1 to 3 months), in 34. The esophageal pH test was performed before operation in 22 patients, shortly after discharge in 27, and later in 30 patients. The clinical results were considered satisfactory in 30 patients (88%) after follow-up ranging from 18 to 33 months (average, 23 months). Before the procedure, the abdominal compression test was positive in 25 of 30 patients (83%). In early postoperative studies it was positive in 1 out of 34 patients (3%), but in the second series of postoperative studies it was positive in 9 out of 32 (28%). After instillation of hydrochloric acid into the stomach, the esophageal pH test was considered positive in 17 out of 22 patients in preoperative studies (77%). In early postoperative studies the test was positive in 3 out of 27 patients (11%) and one year later, in 7 out of 30 (23%). The later postoperative studies showed a higher number of positive reflux tests than the early studies, 28 and 23% positive in manometric and pH tests, respectively.
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Tarazona V, Padilla J, Blasco E, Cantó A, Zarza A, Pastor J, París F, Romar A. Resultados en el tratamiento quirurgico del cancer de pulmon. Factores pronosticos. Arch Bronconeumol 1978. [DOI: 10.1016/s0300-2896(15)32593-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The technique, indications, and complications of diagnostic thoracoscopy are described. Two hundred and eight explorations have been performed in our service in the last seven years. From 137 pleural malignancies we have obtained an unequivocal positive biopsy in 129 (94%) with a minimum number of complications and no mortality. From our experience we conclude that thoracoscopy, when porperly performed, is diagnostic in most pleural conditions.
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45
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Zarza A, Blasco E, Cantó A, Casillas M, Padilla J, Pastor J, Tarazona V, París F. Estabilizacion quirurgica del torax flaccido traumatico. Arch Bronconeumol 1977. [DOI: 10.1016/s0300-2896(15)32688-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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46
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París F, Tarazona V, Blasco E, Cantó A, Casillas M, Pastor J, Zarza AG, Padilla J. [Early diagnosis, tumor extension and results of exeresis of primary epidermoid bronchial cancers]. Bronchopneumologie 1977; 27:47-63. [PMID: 884567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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47
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Abstract
Since 1970 we have stabilized the ribs to correct paradoxical movement of the chest wall in chest injuries, using an original technique, in order to avoid as far as possible the need for long-term chest wall stabilization by intermittent positive pressure respiration (IPPR). The technical details of surgical stabilization are described, and the different types of stainless steel struts are shown. Type I was originally used either as an intramedullary nail or as an external brace. Types II and III were designed for external fixation of the strut to the rib. Treatment of 29 patients with severe flail chest, classified into four groups is shown: group I was treated by IPPR, group II by IPPR plus surgical stabilization, group III by surgical stabilization only, and group IV by surgical stabilization after exploratory thoracotomy. The clinical results are discussed. We conclude that surgical stabilization of the paradoxial movement of the chest wall can avoid the use of the respirator or at least reduce the interval of IPPR to a short period during the initial recovery from trauma. Using type III struts, we have obtained stabilization of the flail chest in all cases even in patients with severe anterior paradoxical movement. The patients' tolerance of surgical stainless steel struts was good.
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48
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Abstract
Up to December 1973, we had performed 100 mediastinoscopies for lung carcinoma. Fifty-two were positive and 48 negative. In 80 cases there was clinical or radiological suspicion of mediastinal invasion. With radiological evidence of mediastinal node involvement exploration was positive in 32 out of 35 cases, when chest radiography findings were equivocal in 19 out of 45, and when radiology of the mediastinum was normal in only one of 20 cases. Mediastinoscopy was more frequently positive when the carcinoma was oat-cell or anaplastic. Of 48 patients with negative biopsies, 41 were explored. In 26 the carcinoma extended beyond the lung. In 1973 we circularized 83 thoracic surgeons concerning (1) the use of mediastinoscopy for patients with lung carcinoma assessed for surgery, (2) the significance of mediastinal node involvement, (3) the results of radiotherapy alone in patients rejected for surgery, and (4) the survival rate in patients with positive mediastinal nodes treated with surgery alone or together with radiotherapy. The replies to the questionnaire are summarized. The authors emphasize the usefulness of mediastinoscopy but state that care must be taken when deciding to withhold operation for a possible cure.
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49
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Abstract
París, F., Tarazona, V., Casillas, M., Blasco, E., Cantó, A., Pastor, J., and Acosta, A. (1973).Thorax, 28, 631-636. Hernia of Morgagni. Nine patients with Margagni's hernia of the diaphragm are reported, seven of whom have been operated on. Four patients had gastrointestinal symptoms, two respiratory symptoms, and one retrosternal pain; the other two were asymptomatic. In the first case the diagnosis was made at the time of thoracotomy, in the other eight it was suggested by radiological studies. The standard midline epigastric incision was used for repair in four cases and thoracotomy in two; the last patient was operated on through a preperitoneal subxiphoid route. This route has the advantage of not requiring a wide incision of peritoneum.
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50
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Abstract
Nine cases of diaphragmatic eventration are presented in infants, seven of whom required surgery. All were seen during the first 19 months of life and seven were less than 1 year old. Although differing from other studies, our cases show a predominance of right-sided lesions. Respiratory symptoms were present in most cases, and digestive symptoms appeared in a lesser number of cases. The radiological changes were pronounced in seven of the nine cases, the dome of the diaphragm reaching to the fourth to fifth intercostal spaces. Regarding surgical technique, the authors favour diaphragmatic plication through the thorax. This gave excellent clinical and radiological results and was without mortality or complications.
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