Posterior mediastinal dumbbell ganglioneuroma with fatty replacement.

We report a case of a posterior mediastinal dumbbell ganglioneuroma with fatty replacement on CT and MRI. Most dumbbell tumours are neurogenic in origin. Fatty replacement of non-lipomatous malignancies is rare. This report suggests that a ganglioneuroma with fatty replacement should be added to the differential diagnosis of fat-containing posterior mediastinal tumours.

Calcified endobronchial leiomyoma.

We report a case of calcified endobronchial leiomyoma in the left main bronchus. Leiomyoma of the airways is a rare benign tumour, usually described as a solitary lesion and located in the membranous portion of the lower third of the trachea and rarely in the bronchi. Chest CT showed a well-defined, calcified, polypoid endobronchial mass with a broad stalk in the left main bronchus.

Comparison of canine single and sequential bilateral lung transplant model for lung preservation study.

The purpose of this study was to compare canine sequential bilateral lung transplantation (SBLT) with left single lung transplant (LSLT) models. After 24 hours of lung preservation with low potassium/dextran glucose (LPDG) solution, seven SBLT procedures were performed using mongrel dogs. The comparative group including nine cases of LSLT. After completion of each transplant, the dogs were maintained on a ventilator for 3 hours. Thereafter serial hemodynamics were evaluated with recipients with chest X-ray, computed tomography, and lung perfusion scan checked at 2 hours after transplantation. Pathological evaluations were also performed. Five of seven SBLT successfully completed the whole assessment, all LSLT survived. In SBLT, pulmonary arterial pressure and pulmonary vascular resistance were significantly elevated, but recovered 3 hours after reperfusion. The ultrastructural aspects of alveolae and pulmonary artery endothelium showed a reversible mild injury 24 hours after lung preservation and reperfusion. The present study suggests that the canine SBLT model using LPDG solution provides an excellent preservation effect and is more physiological as the dog is completely dependent on the function of the transplanted lung.

Pulmonary preservation effect of nitroglycerine in isolated rat lung reperfusion model.

PURPOSE: Though nitric oxide has many favorable protective effects on donor lungs, it may also have cytotoxic side effects. In this regard, we investigated whether administration of nitroglycerine, a nitric oxide donor, could minimize ischemia-reperfusion injury in an isolated rat lung reperfusion model. MATERIALS AND METHODS: Thirty-five Sprague-Dawley rats were used for this experiment. The nitroglycerine (NTG) group (n = 18) received the drug intravenously and the 17 control group hosts were treated with the same amount of normal saline. The heart-lung block was retrieved, weighed, and maintained in University of Wisconsin solution for 24 hours at 10 degrees C. Reperfusion was performed using human blood diluted in Krebs-Hensleit solution for 60 minutes. Peak inspiratory pressure, pulmonary artery pressure, and blood gas analysis were performed. After 60 minutes of reperfusion, the amount of protein in bronchoalveolar lavage (BAL) fluid and the myeloperoxidase (MPO) activity in the lung were measured. RESULTS: There were no major statistical differences between the two groups in peak inspiratory pressure and pulmonary artery pressure, but the NTG group maintained lower pulmonary artery pressure during the whole period of reperfusion. Oxygen tension in the NTG group was significantly higher, whereas there were no differences in carbon dioxide tension, BAL fluid, protein, or MPO activity. CONCLUSION: Administration of NTG before donor lung preservation resulted in better lung protection, a possible strategy for clinical application.

Ultrastructural evaluation of the protective effect of nitroglycerin in preservation-reperfusion injury of rat lungs.

AIM OF STUDY: Nitric oxide (NO) has been reported as a favorable protective supplement in donor lung preservation, but related ultrastructural studies are rare in the literature. This study was performed to assess the ultrastructural changes and to evaluate the protective effect of NO as donor nitroglycerin (NTG) treatment of ischemia-reperfusion injury in rat lungs. MATERIALS AND METHODS: Fifteen Sprague-Dawley rats weighing 300 to 350 g were used in this study. The NTG group (n = 5) used intravenous administration followed by mixture in the University of Wisconsin (UW) solution. For the non-NTG group (n = 5), we injected the same amount of normal saline intravenously followed by admixture in the UW solution. The heart-lung blocks were removed, weighed, and kept in UW solution for 24 hours at 10 degrees C. Reperfusion using human blood diluted in Krebs-Hensleit solution was done for 60 minutes. For the control group (n = 5), we injected the same amount of normal saline intravenously, and removed the lungs with no preservation and reperfusion procedures. RESULTS: The non-NTG group showed multiple patchy areas of alveolar collapse with marked swelling and destruction of type I epithelial cells, loss of type II cell surfactant granules, endothelial swelling and papillary projection, interstitial edema, and alveolar macrophages with active phagocytosis of the destroyed materials. The NTG group showed similar ultrastructural changes, but in a lesser severity compared with the non-NTG group. CONCLUSION: Administration of the NTG reduced the ischemia-reperfusion injury in the rat donor lungs. Ultrastructural examination was an effective tool to evaluate the protective effect of NTG in ischemia-reperfusion procedures of donor lungs.