Postoperative early laboratory changes and follow-up process of patients underwent hyperthermic intrathoracic chemotherapy.

BACKGROUND: The aim of combining hyperthermic intrathoracic chemotherapy (HITHOC) with surgery is to achieve local control in patients with pleural malignancies. Liver and kidney dysfunction resulting from this procedure have been reported in the literature. The objective of the study is to examine whether the laboratory abnormalities observed during the initial period persist until day 30. METHODS: The study conducted a retrospective analysis of the blood glucose levels, renal function markers, and hepatic function markers of 30 patients who underwent pleurectomy-decortication and HITHOC for pleural mesothelioma from January 2010 to April 2022. The measurements were taken in the postoperative period on the first four and 30th days. The study analyzed the initial and final laboratory results caused by the procedure. RESULTS: Out of the total of 30 patients, 29, 28, 14, and 12 patients had elevated glucose levels on the first four days after the surgery, respectively. There was no association between glucose abnormalities and preoperative-postoperative diabetes mellitus. A minority of patients experienced atypical alterations in kidney and liver functions during the initial postoperative period. There was no apparent relationship between the renal and hepatic functions in the early and late periods after the surgery. CONCLUSION: Although there were fluctuations in glucose levels and renal and hepatic functions in the early period after surgery, there were no persistent alterations in these parameters by day 30. Elevated glucose levels during the early period were not associated with the development of newly diagnosed diabetes mellitus after surgery. The findings of our study provide evidence that HITHOC is a favorable and well-tolerated treatment option for mesothelioma.

Enhancing Lung Cancer Survival Prediction: 3D CNN Analysis of CT Images Using Novel GTV1-SliceNum Feature and PEN-BCE Loss Function.

Lung cancer is a prevalent malignancy associated with a high mortality rate, with a 5-year relative survival rate of 23%. Traditional survival analysis methods, reliant on clinician judgment, may lack accuracy due to their subjective nature. Consequently, there is growing interest in leveraging AI-based systems for survival analysis using clinical data and medical imaging. The purpose of this study is to improve survival classification for lung cancer patients by utilizing a 3D-CNN architecture (ResNet-34) applied to CT images from the NSCLC-Radiomics dataset. Through comprehensive ablation studies, we evaluate the effectiveness of different features and methodologies in classification performance. Key contributions include the introduction of a novel feature (GTV1-SliceNum), the proposal of a novel loss function (PEN-BCE) accounting for false negatives and false positives, and the showcasing of their efficacy in classification. Experimental work demonstrates results surpassing those of the existing literature, achieving a classification accuracy of 0.7434 and an ROC-AUC of 0.7768. The conclusions of this research indicate that the AI-driven approach significantly improves survival prediction for lung cancer patients, highlighting its potential for enhancing personalized treatment strategies and prognostic modeling.

Calcific pulmonary nodule, is it wandering?

Wandering pulmonary nodule is defined as a nodule with morphologically identical features found in different regions of the lung on different imaging studies. In this article, we report a 61-year-old patient who was examined for cough and found to have an 8 mm calcific nodule in the lower lobe of the left lung on computed tomography (CT) scan (Fig. 1A, B). On follow-up CT scan two years later, a nodule with the same morphology and size was detected in the same lobe but at a different location (Fig. 1C, D).

Bibliometric analysis of 40 most cited articles comparing video-assisted thoracic surgery and robotic-assisted thoracic surgery in lung cancer (1997-2021).

Background: In recent years, conventional thoracoscopic surgery has been accepted as the traditional treatment method in the non-small cell lung cancer (NSCLC). VATS and RATS, which are the techniques of this surgical method, have been increasing their effectiveness and applicability of late years. The aim of this bibliometric analysis is to evaluate the importance and efficiency of articles comparing VATS and RATS techniques. Materials and methods: Studies comparing VATS and RATS published between 1997 and 2021 were identified in the Web of Science database (accessed on 31. 12. 2021). The 40 most cited studies were analyzed in terms of publication years, country of study, authors, institutions that the authors were affiliated with, journal, journal address and impact factor. Results: While an article was cited a maximum of 187 times when the citations made by the authors were excluded from the analysis, it was observed that all publications were cited a total of 1946 times. It was seen that an average of 51. 30 ± 47. 73 (8-187) articles were cited. In the 25-year, the highest number of publications was reached in 2019, while eight articles were published this year. The Annals of Thoracic Surgery (n = 13, 32. 5 %) was the journal in which the articles in the list were published the most. Most of the articles in our study (n = 31, 77.5 %) were published in US journals. While many studies presented more than one topic and analysis, the topic of most interest in 19 (47.5 %) studies was postoperative complications. Conclusion: This bibliometric analysis reflects important and qualified articles comparing VATS and RATS technique in thoracic surgery, but it can also be used to explain or explain the performance and results of these techniques, their positive and negative aspects, and their superiority over each other.

Pleural angiosarcoma presenting with spontaneous hemothorax.

Angiosarcomas (ASs) are very rare and constitute 1-2% of soft tissue malignancies. Primary pleural AS (PPAS) is a very rare neoplasm, with only 50 cases reported in the literatüre, and is a tumor with a high tendency for local recurrence and metastasis, with an aggressive course and a generally poor prognosis unless diagnosed early. It originates from the endothelial cells of small blood vessels and therefore can affect many organs. The etiology and definitive method in the treatment is still unclear. Patients usually present with nonspecific symptoms such as cough, dyspnea, chest pain, and hemoptysis. Recurrent exudative or hemorrhagic pleural effusion may develop due to its pleural location. The diagnosis can be made by histopathological and immunohistochemical examinations of excisional biopsy specimens. The effectiveness of chemotherapy and radiotherapy is weak and can be applied for palliative purposes. Surgical approach can be used for diagnostic and palliative purposes. Due to the high degree of malignancy and insidious course of PPAS, patients usually die within months after diagnosis. In these patients, surgical exploration is important for the diagnosis and palliative/definitive treatment of the disease. We present a 61-year-old male patient who presented with dyspnea, chest pain, and massive pleural effusion findings in the left hemithorax and was diagnosed with PPAS as a result of pleural biopsy.

Impact of ligating gonadal or adrenal collateral veins with the left renal vein on renal function and histology in right-nephrectomized rats.

BACKGROUND: In cases of trauma to the left renal vein (LRV), its ligation near the inferior vena cava (IVC) is considered, but the consequences are not always good. We investigated the role of collateral venous drainage after ligation of the LRV by studying the renal function and histology after ligation of the LRV near the IVC alone or with ligation of the gonadal or adrenal collaterals, in right-nephrectomized (RN) rats. MATERIAL AND METHODS: Ligation of the LRV near the IVC alone (group 1) or with ligation of the adrenal (group 2) or gonadal (group 3) collaterals was studied in RN Wistar rats (n=18 per group). The renal histopathology (ischemic cortical necrosis) and functional status (urea, creatinine, sodium, and potassium) were compared. RESULTS: In RN rats, the results were better when ligating the LRV near the IVC alone or with the adrenal collaterals [mortality 4/18 (22.2%) and 3/18 (16.7%), respectively] than when ligating the LRV near the IVC plus the gonadal collaterals [mortality 15/18 (83.3%)] (p<0.0001). All early deaths occurred within three days and resulted from serious histopathological (ischemic cortical necrosis) and functional (increased urea, creatinine, and potassium; decreased sodium) renal damage. CONCLUSION: In right-nephrectomized rats, the LRV near the IVC and the adrenal collateral can be ligated, while the gonadal collateral should be preserved.

Type 1 gastric carcinoid tumor: another extrahepatic manifestation of hepatitis C virus infection?

A 67 year-old female with a 10-year history of cirrhosis due to hepatitis C virus who developed a gastric carcinoid tumor of the corpus is described. Carcinoid tumor was identified during her last routine gastroscopic evaluation for portal hypertension. In the case, serum parietal cell antibodies, hypergastrinemia and atrophic gastritis were also found. Chronic hepatitis C virus infection is known to induce clinical and laboratory signs of autoimmunity. But the question of whether hepatitis C virus plays a pathogenic role in the development of gastric carcinoid tumor is unknown. As far as we know, this is the first report describing gastric carcinoid tumor in hepatitis C virus induced chronic liver disease. We suggest that the possibility of the development of autoimmune atrophic gastritis and carcinoid tumors should be considered in patients with chronic hepatitis C that coexists with autoimmune diseases and has positive parietal cell antibodies.