Perforación yatrogénica de la arteria pulmonar por tubo de drenaje pleural / Iatrogenic perforation of the pulmonary artery by a pleural drain

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Procedimiento de autotrasplante pulmonar en el cerdo como modelo experimental para el estudio del síndrome de isquemia-reperfusión / Experimental Swine Lung Autotransplant Model to Study Lung Ischemia-Reperfusion Injury

Introducción: El daño pulmonar agudo por isquemia reperfusión (IR) ha sido estudiado fundamentalmenteen modelos experimentales y clínicos con IR fría. Son limitados los estudios que profundizan en lasalteraciones bioquímicas durante la IR normotérmica (caliente). El objetivo del este trabajo es presentarun modelo de autotrasplante pulmonar en cerdo para el estudio de las fases más precoces del síndromede IR normotérmica pulmonar.Animales y métodos: Seis cerdos de la raza Large-White fueron sometidos a neumonectomía izquierda,lobectomía craneal ex situ, reimplantación del lóbulo caudal y reperfusión del mismo durante 30 min.Durante el procedimiento se analizaron diferentes parámetros para identificar cambios hemodinámicos,gasométricos y bioquímicos en el modelo. El estudio estadístico se realizó con pruebas no paramétricas.Resultados: Tras la isquemia, se observó en tejido pulmonar un aumento significativo (p < 0,05) de metabolitosde peroxidación lipídica, de citoquinas y quemoquinas proinflamatorias (TNF- , IL-1 y MCP-1),de actividad leucocitaria (mieloperoxidasa o MPO), de actividad óxido nítrico sintasa inducible y de laproteína quinasaMAPKp38, mientras que se observóundescenso de actividad tisular de las formas constitutivasde NOS y de monóxido de carbono sérico. Estas alteraciones se mantuvieron o acentuaron durantela reperfusión, donde se observó también una mayor actividad tisular hemo-oxigenasa constitutiva.Conclusiones: Se presenta un procedimiento experimental de IR normotérmica pulmonar describiendo enprofundidad cambios hemodinámicos, gasométricos y bioquímicos. Tanto el modelocomolos parámetrosanalizados podrían ser útiles en el estudio de nuevas terapias moduladoras del da˜no pulmonar agudo ensituaciones clínicas de IR normotérmica(AU)

Introduction: Ischemia-reperfusion (IR) lung injury has been investigated extensively on clinical andexperimental models of cold ischemia. However, relatively few studies examine the detailed biochemicalchanges occurring during normothermic (warm) IR.The objective of this work was to establish an experimental lung autotransplant model to be carried outon pigs in order to study the early stages of normothermic lung IR.Animals y methods: Six Large-White pigs underwent a lung autotransplant which entailed left pneumonectomy,ex situ cranial lobectomy, caudal lobe reimplantation and its reperfusion for 30 min. Throughoutthe procedure, several parameters were measured in order to identify hemodynamic, gasometric andbiochemical changes. Non-parametric statistical analyses were used to compare differences between periods. Results: After ischemia, a significant increase (P < 0.05) in lipid peroxidation metabolites, proinflammatorycytokines and chemokines (TNF- , IL-1 y MCP-1), neutrophil activation, inducible nitric oxide synthaseactivity and protein-kinase MAPK p38 levels were observed in lung tissue. However, constitutive nitricoxide synthase activity in lung tissue and carbon monoxide plasma levels were decrease. The same heldtrue throughout the reperfusion period, when an increase in the constitutive heme-oxygenase activitywas also shown.Conclusions: An experimental model of normothermic lung IR injury is presented and detailed changes inhemodynamic, gasometric and biochemical parameters are shown. Both the model and the studied parametersmay be clinically useful in future investigations testing new therapies to prevent normothermicIR induced lung injury(AU)

Experimental Swine lung autotransplant model to study lung ischemia-reperfusion injury.

INTRODUCTION: Ischemia-reperfusion (IR) lung injury has been investigated extensively on clinical and experimental models of cold ischemia. However, relatively few studies examine the detailed biochemical changes occurring during normothermic (warm) IR. The objective of this work was to establish an experimental lung autotransplant model to be carried out on pigs in order to study the early stages of normothermic lung IR. ANIMALS Y METHODS: Six Large-White pigs underwent a lung autotransplant which entailed left pneumonectomy, ex situ cranial lobectomy, caudal lobe reimplantation and its reperfusion for 30 min. Throughout the procedure, several parameters were measured in order to identify hemodynamic, gasometric and biochemical changes. Non-parametric statistical analyses were used to compare differences between periods. RESULTS: After ischemia, a significant increase (P < 0.05) in lipid peroxidation metabolites, proinflammatory cytokines and chemokines (TNF-α, IL-1ß y MCP-1), neutrophil activation, inducible nitric oxide synthase activity and protein-kinase MAPK p38 levels were observed in lung tissue. However, constitutive nitric oxide synthase activity in lung tissue and carbon monoxide plasma levels were decrease. The same held true throughout the reperfusion period, when an increase in the constitutive heme-oxygenase activity was also shown. CONCLUSIONS: An experimental model of normothermic lung IR injury is presented and detailed changes in hemodynamic, gasometric and biochemical parameters are shown. Both the model and the studied parameters may be clinically useful in future investigations testing new therapies to prevent normothermic IR induced lung injury.

Hemangioendotelioma epiteloide pulmonar / Pulmonary Epithelioid Hemangioendothelioma

El hemangioendotelioma epitelioide es una enfermedad de difícil diagnóstico, descrita como un tumor multicéntrico y de escasa actividad metastásica, que aparece con mayor frecuencia en mujeres jóvenes asintomáticas y como un hallazgo casual. El patrón radiológico es heterogéneo. El dato más importante para su diagnóstico es la confirmación histológica de cuerpos de Weibel-Palade, o bien la inmunohistoquímica, con marcadores tumorales específicos como el factor VIII y CD34. Presentamos el caso de una mujer de 73 años en quien de forma casual se detectaron, en una imagen radiológica, nódulos pulmonares múltiples que posteriormente se diagnosticaron como esta entidad tumoral(AU)

Epithelioid hemangioendothelioma is a multifocal tumor that rarely metastasizes. It is difficult to diagnose and is most often an incidental finding in young asymptomatic women. It has a heterogeneous radiologic pattern. The most important diagnostic information is histologic confirmation of Weibel-Palade bodies or immunohistochemistry based on specific tumor markers such as factor VIII and CD34. We report the case of a 73-year-old woman in whom multiple pulmonary nodules detected by chance in a radiograph were subsequently diagnosed as epithelioid hemangioendothelioma(AU)

[Pulmonary epithelioid hemangioendothelioma]. / Hemangioendotelioma epiteloide pulmonar.

Epithelioid hemangioendothelioma is a multifocal tumor that rarely metastasizes. It is difficult to diagnose and is most often an incidental finding in young asymptomatic women. It has a heterogeneous radiologic pattern. The most important diagnostic information is histologic confirmation of Weibel-Palade bodies or immunohistochemistry based on specific tumor markers such as factor VIII and CD34. We report the case of a 73-year-old woman in whom multiple pulmonary nodules detected by chance in a radiograph were subsequently diagnosed as epithelioid hemangioendothelioma.