LncRNA H19 inhibits proliferation and enhances apoptosis of nephroblastoma cells by regulating the miR-675/TGFBI axis.

OBJECTIVE: To investigate the influences of long non-coding ribonucleic acid (lncRNA) H19 on proliferation and apoptosis of nephroblastoma cells. MATERIALS AND METHODS: A total of 5 pairs of nephroblastoma tissues and paraneoplastic tissues were obtained. Gene expression levels of lncRNA H19, microRNA (miR)-675, and transforming growth factor beta induced (TGFBI) were detected via quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR). Their regulatory effects on the viability of nephroblastoma cells were examined by Cell Counting Kit-8 (CCK-8) assay. Finally, the apoptosis level in each group was detected through TUNEL assay, and the protein expressions of TGFBI and Caspase-8 were examined using Western blotting (WB) assay. RESULTS: The gene expression levels of lncRNA H19 and miR-675 were markedly downregulated in nephroblastoma tissues (p<0.05), while that of TGFBI was notably upregulated (p<0.05). LncRNA H19 could reduce the proliferative ability of HFWT cells (p<0.05) and stimulates apoptosis rate (p<0.05). It upregulated the expressions of miR-675 and Caspase-8 (p<0.05), and downregulated TGFBI (p<0.05). Besides, miR-675 was able to upregulate Caspase-8 (p<0.05) and downregulate TGFBI (p<0.05). In addition, the protein expression of Caspase-8 was downregulated (p<0.05), while that of TGFBI was upregulated (p<0.05) after the knockdown of miR-675 in HFWT cells. CONCLUSIONS: LncRNA H19 may inhibit TGFBI expression by regulating miR-675 level, so as to weaken the proliferation and enhance the apoptosis of nephroblastoma cells.

Preparation of icariin/TiO2 nanotube composite coating on pure titanium surface and analysis of early drug release.

The article "Preparation of icariin/TiO2 nanotube composite coating on pure titanium surface and analysis of early drug release" by F.-F. Wang, Y. Li, H.-C. Liu, published in Eur Rev Med Pharmacol Sci 2019; 23(5): 1864-1873 has been withdrawn.

Preparation of icariin/TiO2 nanotube composite coating on pure titanium surface and analysis of early drug release.

OBJECTIVE: The surface modification of pure titanium and the improvement of the early osseointegration of titanium implants are research hotspots currently. This study aimed to load icariin onto the surface of TiO2 nanotube to form the composite coating, and to study the amount of loaded drug and the importance of early release. MATERIALS AND METHODS: The TiO2 nanotube was formed on the surface of smooth pure titanium via anodic oxidation, and both smooth pure titanium and TiO2 nanotube were characterized using the scanning electron microscope, atomic force microscope and contact angle apparatus. Moreover, icariin was loaded onto the surface of pure titanium and TiO2 nanotube using the soaking method. RESULTS: The amount of early drug release in both types of materials was determined via high-performance liquid chromatography. The amount of loaded drug was calculated, and the curves of cumulative release amount and cumulative release percentage were plotted. The TiO2 nanotube had a diameter of 80 nm with greater roughness than that of pure titanium (p<0.05) and smaller contact angle than that of pure titanium (p<0.05). The cumulative drug release amount in the first 14 d and the curve of cumulative drug release in the first 4 h in icariin/TiO2 nanotube group were significantly larger and higher than those in the icariin/pure titanium group. The curve of cumulative drug release percentage was flatter and the release time was longer in icariin/TiO2 nanotube group than those in the icariin/pure titanium group. CONCLUSIONS: Our results indicate that the icariin/TiO2 nanotube composite coating can provide a higher drug loading amount with a sustained-release effect.

A study on PLGA sustained release icariin/titanium dioxide nanotube composite coating.

OBJECTIVE: The Chinese medicine icariin with osteoinduction and osteogenesis abilities is loaded onto the surface of TiO2 nanotubes to form icariin/TiO2 nanotube composite coating, which can synergistically enhance the osseointegration around the implant. MATERIALS AND METHODS: However, the half-life of icariin is short, and the sustained release effect of TiO2 nanotubes cannot meet the long-term stable drug release requirement. Therefore, in order to enhance the sustained release effect of icariin/TiO2 nanotube composite coating, in this study, polymer PLGA was applied to the composite coating by overlay method and mixing method. Scanning electron microscopy and release detection were performed to study the effects of two PLGA loading methods on the loading and early release of composite coatings. RESULTS: Results showed that the PLGA loading and sustained release effect was stronger than that of TiO2 nanotubes. The sustained release effect was mainly manifested in the rapid release phase. The release time of the TiO2nanotube drug-loaded composite coating was 9 days. Overlay method and mixing method extended the drug release time to 12 d and 10 d, respectively. CONCLUSIONS: Therefore, PLGA can enhance the loading and sustained release properties of icariin/TiO2 nanotube composite coating. Overlay method has better sustained release effect, and the mixing method has better loading performance.

CXCL13 inhibition induce the apoptosis of MDA-MB-231 breast cancer cells through blocking CXCR5/ERK signaling pathway.

OBJECTIVE: Treatment of the high-risk triple negative breast cancer (TNBC) is a critical clinical challenge. Here we aimed to explore a novel strategy for TNBC treatment by blocking the tumor-associated chemokine CXCL13 in the MDA-MB-231 TNBC cells. MATERIALS AND METHODS: MDA-MB-231 cells were treated with anti-CXCL13 antibodies (inhibition group), or phosphate-buffered saline (PBS) (control group), followed by determining the levels of interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-α) and transforming growth factor beta-1 (TGF-ß1) with enzyme-linked immunosorbent assay (ELISA). The effects of CXCL13 inhibition on cell proliferation and apoptosis were assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and flow cytometry, respectively. Quantitative Real Time-PCR (qRT-PCR) and Western blot were used to compare the levels of CXCL13, CXCR5, extracellular signal-regulated kinase (ERK). The levels of cyclin D1 and cleaved caspase-9 were detected by Western blot. RESULTS: The levels of IL-1, TNF-α and TGF-ß1 in MDA-MB-231 cells treated with anti-CXCL13 antibodies were significantly downregulated (p<0.05). Meanwhile, CXCL13 blockade decreased the cell proliferation and increased the apoptosis rate of MDA-MB-231 cells. The inhibition of CXCL13 led to marked reduction in CXCL13 and CXCR5 mRNA and an increase in ERK mRNA. The inhibition of CXCL13 resulted in the downregulation of CXCL13, CXCR5, p-ERK/ERK, cyclin D1 and upregulation of cleaved caspase-9 proteins. CONCLUSIONS: CXCL13 blockade effectively suppressed the proliferation of MDA-MB-231 cells by promoting cell apoptosis. This effect is presumably associated with the downregulation of CXCL13 and suppression of the CXCR5/ERK signaling pathway.

miR-487b mitigates allergic rhinitis through inhibition of the IL-33/ST2 signaling pathway.

OBJECTIVE: To investigate the potential effect of miR-487b/IL-33-ST2 axis on the pathology of allergic rhinitis (AR) and the relevant mechanism. PATIENTS AND METHODS: The expression level of interleukin-33 (IL-33), a homolog of sulfotransferase (ST2), and miR-487b were detected in patients with or without allergic rhinitis. Luciferase assay was performed to evaluate the interaction between miR-487b and IL-33, and the effects of miR-487b/IL-33-ST2 axis on allergic rhinitis mice were determined by established allergic rhinitis model in mice by ovalbumin (OVA). The levels of OVA-specific immunoglobulin E (Ig-E), proinflammatory cytokines (IL-4, IL-5, and IL-13), and pathological alterations were detected. RESULTS: The level of IL-33 and its specific ligand ST2 were found increased in allergic rhinitis patients while miR-487b expression level was markedly repressed. To confirm whether miR-487b has a regulation effect on IL-33, we checked it in three publicly available algorithms, TargetScan, miRDB, and microRNA. We found that IL-33 is a direct target of miR-487b, and Luciferase assays confirmed our hypothesis, the subsequent experiments showed that up-regulation of miR-487b could inhibit expression of IL-33 and ST2, resulting in the decrease of the immunoglobulin E (Ig-E), proinflammatory cytokines and mitigation of pathological alterations. CONCLUSIONS: Our research discovered the suppressor function of miR-487b in allergic rhinitis and revealed that miR-487b/IL-33-ST2 axis may be a potential therapeutic target for the treatment of allergic rhinitis.

Coherent backscattering in quasi-ballistic ultra-high mobility GaAs/AlGaAs 2DES.

A small and narrow negative-magnetoresistance (MR) effect that appears about null magnetic field over the interval -0.025 ≤ B ≤ 0.025 T in magnetotransport studies of the GaAs/AlGaAs 2D system with µ ≈ 107cm2/Vs is experimentally examined as a function of the sample temperature, T. The temperature dependent magnetoresistance data were fit using the Hikami et al. theory, without including the spin-orbit correction, to extract the inelastic length, li, which decreases rapidly with increasing temperature. It turns out that li < le, where le is the elastic length, for all T. Thus, we measured the single particle lifetime, τs, and the single particle mean free path ls = vFτs. A comparison between li and ls indicates that li > ls. The results suggest that the observed small and narrow magnetoresistance effect about null magnetic field could be a manifestation of coherent backscattering due to small angle scattering from remote ionized donors in the high mobility GaAs/AlGaAs 2DES.

Economic impact and cost-effectiveness of fracture liaison services: a systematic review of the literature.

Fracture liaison services (FLS), implemented in different ways and countries, are reported to be a cost-effective or even a cost-saving secondary fracture prevention strategy. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards. This study summarizes the economic impact and cost-effectiveness of FLS implemented to reduce subsequent fractures in individuals with osteoporosis. This systematic review identified studies reporting economic outcomes for FLS in osteoporotic patients aged 50 and older through a comprehensive search of MEDLINE, EMBASE, Cochrane Central, and PubMed of studies published January, 2000 to December, 2016. Grey literature (e.g., Google scholar, conference abstracts/posters) were also hand searched through February 2017. Two independent reviewers screened titles and abstracts and conducted full-text review on qualified articles. All disagreements were resolved by discussion between reviewers to reach consensus or by a third reviewer. In total, 23 qualified studies that evaluated the economic aspects of FLS were included: 16 cost-effectiveness studies, 2 cost-benefit analyses, and 5 studies of cost savings. Patient populations varied (prior fragility fracture, non-vertebral fracture, hip fracture, wrist fracture), and FLS strategies ranged from mail-based interventions to comprehensive nurse/physician-coordinated programs. Cost-effectiveness studies were conducted in Canada, Australia, USA, UK, Japan, Taiwan, and Sweden. FLS was cost-effective in comparisons with usual care or no treatment, regardless of the program intensity or the country in which the FLS was implemented (cost/QALY from $3023-$28,800 US dollars (USD) in Japan to $14,513-$112,877 USD in USA. Several studies documented cost savings. FLS, implemented in different ways and countries, are reported to be cost-effective or even cost-saving. This presumed favorable cost-benefit relationship is encouraging and lends support to expanded implementation of FLS per International Osteoporosis Foundation Best Practice Standards.

Mutual influence between current-induced giant magnetoresistance and radiation-induced magnetoresistance oscillations in the GaAs/AlGaAs 2DES.

Radiation-induced magnetoresistance oscillations are examined in the GaAs/AlGaAs 2D system in the regime where an observed concurrent giant magnetoresistance is systematically varied with a supplementary dc-current, I dc . The I dc tuned giant magnetoresistance is subsequently separated from the photo-excited oscillatory resistance using a multi-conduction model in order to examine the interplay between the two effects. The results show that the invoked multiconduction model describes the observed giant magnetoresistance effect even in the presence of radiation-induced magnetoresistance oscillations, the magnetoresistance oscillations do not modify the giant magnetoresistance, and the magnetoresistance oscillatory extrema, i.e., maxima and minima, disappear rather asymmetrically with increasing I dc . The results suggest the interpretation that the I dc serves to suppress scattering between states near the Fermi level in a strong magnetic field limit.

NUDT15 gene polymorphism related to mercaptopurine intolerance in Taiwan Chinese children with acute lymphoblastic leukemia.

A recent study identified a variant of the NUDT15 gene (rs116855232 C>T) associated with intolerance to thiopurine in Korean patients with Crohn's disease. This study prompted us to substantiate the finding in a Taiwanese population. Four hundred and four children with acute lymphoblastic leukemia (ALL), and 100 adults with chronic immune thrombocytopenic purpura or localized lymphoma having normal bone marrow were examined. Two candidate gene approaches, pyrosequencing for NUDT15 and TaqMan assay for thiopurine methyltransferase (TPMT) genotyping (rs1142345 A>G), were performed. We showed a risk allele frequency of NUDT15 of 11.6% in children with ALL and 15.5% in adults. By contrast, the risk allele frequency of TPMT was only 1.6% in children with ALL and 0.5% in adults. The high frequency of risk variant for NUDT15, but not the very low frequency of risk variant for TPMT, was closely associated with the intolerance to mercaptopurine in children with ALL in Taiwan, contrast to that of European descent. In regard to NUDT15 polymorphism, the maximal tolerable daily doses of mercaptopurine in homozygotes, heterozygotes and wild-type groups were 9.4 mg m-2, 30.7 mg m-2 and 44.1 mg m-2, respectively. The outcomes did not differ significantly among the different genotypes.

Correlation research on the protein expression (p75NTR, bax, bcl-2, and caspase-3) and cortical neuron apoptosis following mechanical injury in rat.

OBJECTIVE: In this study, we aimed to survey the role of p75NTR, bax, bcl-2, and caspase-3 in the progress of traumatic brain injury (TBI). MATERIALS AND METHODS: A mechanical trauma model of vital neurons was established by putting external pressure, contusion and centrifugal acceleration on neurons. Morphological change, survival rate, assay of LDH activity, and apoptosis rate were evaluated for mild, medium and severe injury models. The expression of bax, bcl-2, caspase-3, p75NTR, p75NTR mRNA was determined by immunohistochemistry, immunofluorescence, Western blotting and RT-PCR. RESULTS: There was a transient high level Bcl-2 protein within 2 h after injury to increase neuronal tolerance and avoid apoptosis. Subsequently p75NTR, Bax/Bcl-2, and Caspase-3 reached their peaks from 48 to 72 h accompanied with the maximum apoptosis rate. CONCLUSIONS: Our results suggest that apoptosis ratio in varying degree injury groups are correlated with the expression level of p75NTRmRNA, p75NTR, Caspase-3, Bax/Bcl-2 ratio.

Dual Kidney Transplantation From Pediatric Donors to Adult Recipients.

BACKGROUND: The organ shortage is a global problem. A potential approach to expanding the deceased donor pool is to harvest organs from pediatric patients. METHODS: Seven cases of dual kidney transplantation from pediatric donors to adult recipients were performed between 2012 and 2014 in our center. The proximal end of the donor aorta (AO) was anastomosed to the right common iliac artery or external artery. The proximal end of the donor inferior vena cava (IVC) was anastomosed to the right external iliac vein. Recipients received basiliximab or antithymocyte globulin as induction therapy, followed by tacrolimus, mycophenolate mofetil, and prednisone. Prophylactic anticoagulation was not universal in our study. RESULTS: During the 21-month study period, both patient and graft survivals were 100%. No patient showed thrombotic complications. Complications included an acute rejection episode in 1 patient, urine leakage in 2, and anticoagulation related hemorrhage in 1. All recipients had excellent graft function with normal serum creatinine ranging from 0.49 to 1.45 mg/dL and estimated glomerular filtration rate ranging from 56.89 to 145.27 mL/min/1.73 m(2). CONCLUSIONS: Dual kidney transplantation from pediatric donors to adult recipients is a promising way to expand the donor pool. Using the proximal end of the AO/IVC for anastomosis brings satisfactory results.

Hepatitis C virus infection: a risk factor for Parkinson's disease.

Recent studies found that hepatitis C virus (HCV) may invade the central nervous system, and both HCV and Parkinson's disease (PD) have in common the overexpression of inflammatory biomarkers. We analysed data from a community-based integrated screening programme based on a total of 62,276 subjects. We used logistic regression models to investigate association between HCV infection and PD. The neurotoxicity of HCV was evaluated in the midbrain neuron-glia coculture system in rats. The cytokine/chemokine array was performed to measure the differences of amounts of cytokines released from midbrain in the presence and absence of HCV. The crude odds ratios (ORs) for having PD were 0.62 [95% confidence interval (CI), 0.48-0.81] and 1.91 (95% CI, 1.48-2.47) for hepatitis B virus (HBV) and HCV. After controlling for potential confounders, the association between HCV and PD remained statistically significant (adjusted OR = 1.39; 95% CI, 1.07-1.80), but not significantly different between HBV and PD. The HCV induced 60% dopaminergic neuron death in the midbrain neuron-glia coculture system in rats, similar to that of 1-methyl-4-phenylpyridinium (MPP(+) ) but not caused by HBV. This link was further supported by the finding that HCV infection may release the inflammatory cytokines, which may play a role in the pathogenesis of PD. In conclusion, our study demonstrated a significantly positive epidemiological association between HCV infection and PD and corroborated the dopaminergic toxicity of HCV similar to that of MPP(+) .

Inter- and Intra-individual Variability in the Pharmacokinetics of Agomelatine Tablets in Chinese Healthy Male Subjects.

Agomelatine is an antidepressant with a unique action mechanism differing from conventional antidepressants. The high inter- and intra-individual variability of agomelatine was previously reported, but no exact data values about the inter- and intra-individual variability in AUC and Cmax were mentioned. The current study aimed to determine and evaluate the inter- and intra-individual variability in AUC and Cmax of agomelatine tablets in Chinese healthy male subjects, providing useful information for designing bioequivalence studies of agomelatine. Each of 12 Chinese healthy male subjects received a 25-mg agomelatine tablet on 2 separate periods, and plasma samples were collected up to 24 h after dose and analyzed for agomelatine. Inter- and intra-individual variability in the pharmacokinetic parameters (Cmax, AUC0-t and AUC0-∞) of agomelatine was assessed. High variations in the plasma concentrations of agomelatine could be observed at each sampling time between the different subjects and in one subject on different periods. The inter-individual CVs of Cmax, AUC0-t and AUC0-∞ were 102.20%, 131.74% and 130.59%, respectively. The intra-individual CVs of Cmax, AUC0-t and AUC0-∞ were 84.34%, 49.61% and 50.83%, respectively. The results showed high inter- and intra-individual variability in the pharmacokinetics of agomelatine in Chinese healthy male subjects, and the intra-individual variability at CV>80% should be considered in the design of bioequivalence studies.

Obatoclax induces Beclin 1- and ATG5-dependent apoptosis and autophagy in adenoid cystic carcinoma cells.

OBJECTIVES: Adenoid cystic carcinoma (ACC) is one of the most common salivary gland cancers. The prognosis of adenoid cystic carcinoma is poor for its high frequency of distant metastases and insensitivity to chemotherapy or molecular therapies. This study investigated the effect of Obatoclax on adenoid cystic carcinoma cells and its cytotoxic mechanism. METHODS: Western blot, transmission electron microscopy, and pEGFP-LC3 plasmids transfection were carried out to detect autophagy in ACC cells treated with Obatoclax. 3-MA and RNA interference against Beclin 1 and ATG5 were used to inhibit autophagy. Then we used Western blot and Hochest 33342 staining for apoptosis assessment. Finally, cell viability was assessed by MTT assay. RESULTS: We found that Obatoclax induced cytoprotective autophagy which depended on ATG5 and partly on Beclin 1 in adenoid cystic carcinoma cells. Furthermore, pharmacologically inhibiting Obatoclax-induced autophagy promoted apoptosis. Downregulation of Beclin 1 or ATG5 attenuated the cytotoxicity of Obatoclax by suppressing both autophagy and apoptosis. Finally, when apoptosis was pharmacologically inhibited, autophagic cell death was initiated in adenoid cystic carcinoma cells treated with Obatoclax. CONCLUSION: In summary, Beclin 1 and ATG5 play important roles in regulating both Obatoclax-induced autophagy and apoptosis in adenoid cystic carcinoma.

Evaluating the protective efficacy of antigen combinations against Photobacterium damselae ssp. piscicida infections in cobia, Rachycentron canadum L.

Cobia, Rachycentron canadum L., is a very important aquatic fish that faces the risk of infection with the bacterial pathogen Photobacterium damselae ssp. piscicida, and there are few protective approaches available that use multiple antigens. In the present study, potent bivalent antigens from P. damselae ssp. piscicida showed more efficient protection than did single antigens used in isolation. In preparations of three antigens that included recombinant heat shock protein 60 (rHSP60), recombinant α-enolase (rENOLASE) and recombinant glyceraldehyde-3-phosphate dehydrogenase (rGAPDH), we analysed the doses that elicited the best immune responses and found that this occurred at a total of 30 µg of antigen per fish. Subsequently, vaccination of fish with rHSP60, rENOLASE and rGAPDH achieved 46.9, 52 and 25% relative per cent survival (RPS), respectively. In addition, bivalent subunit vaccines--combination I (rHSP60 + rENOLASE), combination II (rENOLASE + rGAPDH) and combination III (rHSP60 + rGAPDH)--were administered and the RPS in these groups (65.6, 64.0 and 48.4%, respectively), was higher than that achieved with single-antigen administration. Finally, in combination IV, the trivalent vaccine rHSP60 + rENOLASE + rGAPDH, the RPS was 1.6%. Taken together, our results suggest that combinations of two antigens may achieve a better efficiency than monovalent or trivalent antigens, and this may provide new insights into pathogen prevention strategies.

Matrix Effects in the Liquid Chromatography-Tandem Mass Spectrometry Method of Analysis.

Matrix effects are dependent on biological fluid, ionization type, and sample preparation method. Although matrix effects are observed for both ionization types, ESI is especially susceptible, while APCI has proved to be less vulnerable. Sample preparation method has a clear influence on matrix effects as does, in particular, the choice of internal standard. When matrix effects result in severe ion suppression or enhancement of the target analyte by co-eluting residual components, they are typically located in isolated regions of the chromatogram. Postcolumn infusion and postextraction addition methods have been developed for the assessments of matrix effects. Approaches used for eliminating, minimizing, or compensating for matrix effects include improved sample preparation and chromatographic separation, sample dilution, and the utilization of internal standards. Matrix effects may not always be fully circumventable because a perfectly consistent matrix does not exist, but they can be significantly minimized and largely compensated for by various approaches, such as standard addition, matrixmatched calibration, and the use of isotopic analogs of the analytes as internal standards.

Overexpression of Uromodulin-like1 accelerates follicle depletion and subsequent ovarian degeneration.

Murine Uromodulin-like 1 (Umodl1) encodes Ca(2+)-dependent EGF-like membrane-bound proteins. This study presents its novel expression in the immune and female reproductive systems. Upon stimulation by CD3/CD28 antibodies, Umodl1 showed a prompt and robust response in the proliferating CD4(+) T cells, suggesting its implication in immune defense against pathogens. In ovary, Umodl1 is regulated by gonadotropins. Mice carrying extra copies of functional Umodl1 were generated by BAC transgenesis. Defects in the female reproductive system became evident from 4 months of age, manifested by reduced or diminished fertility. Histology revealed that the ovaries contained very few discernible follicles in the cortical region, and were devoid of distinguishable corpus lutea (CL). Among the multilayered preantral follicles, elevated apoptosis was observed in both the oocytes and surrounding granulosa cells (GCs). Furthermore, a high level of PPARγ indicated an abnormal adipogenesis in the mutant ovaries, which resulted in the conversion of GCs into adipocytes. By 6 months of age, all mutant mice became anovulatory. Ovarian tissues including CL, follicles of various stages and associated stromal cells were degenerated. Altered expression of AMH, follicle-stimulating hormone and other ovary-specific marker genes such as Gdf-9, Rnf35, NOHLH and Gcx-1 further demonstrated that the molecular properties of the mutant ovaries have been severely disturbed. This work presents a novel animal model for investigating the pathogenesis of premature ovarian failure or early ovarian ageing.

Single-port thoracoscopic surgery can be a first-line approach for elective thoracoscopic surgery.

BACKGROUND: Thoracoscopic surgery has become very popular in recent years. Conventional thoracoscopic surgery requires three or more port wounds for manipulations of endoscopic instruments. For complicated cancer surgery, more port wounds and a larger thoracotomy wound may be required due to technical reasons. We want to investigate the effectiveness of single-port thoracoscopic approach in elective thoracoscopic surgery for thoracic disease. MATERIALS AND METHODS: From July 1st, 2010 to March 31, 2011, 90 consecutive patients underwent general thoracoscopic surgery performed by the same thoracic surgeon. Two patients with severe trauma and massive bleeding were excluded from the study. All patients included had thoracoscopic surgery with a single-port approach. The surgical outcomes, complications, mortality and conversion rates were recorded and analyzed. RESULTS: A total of 88 patients were included in this study. All these patients were operated on by the same surgeon. For sixty-eight patients, the single-port thoracoscopic approach was used. Nineteen patients were changed to a two-port thoracoscopic approach and one patient's was changed to mini-thoracotomy. Two patients died from terminal lung cancer and severe mitral regurgitation. Complications occurred in six cases. Eighty-seven patients (98.8%) were effectively managed with either single-port or a two-port approach. Only one patient was managed by mini-thoracotomy. CONCLUSION: Elective thoracoscopic surgery performed through a single-port wound is feasible. Single-incisional thoracoscopic surgery can be safely applied as a first-line approach in most cases of elective thoracoscopic procedures.

Pneumothorax, pneumomediastinum and pneumopericardium complications arising from a case of wisdom tooth extraction.

A 25-year-old woman underwent surgical tooth extraction. Several hours after the procedure, the woman complained of severe retrosternal pain and mild dyspnea. Subsequent imaging revealed subcutaneous emphysema from the mandibular region extending to the mediastinum and left side pneumothorax, as well as pneumopericardium. After treatment with antibiotics and analgesics, the patient recovered without any complications.