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Developmental and Comparative Immunology Oct 2022Progress in the phenotypic characterisation of porcine B cells is ongoing, with recent advances in the identification of B1 cell subsets and plasma cells. However,...
Progress in the phenotypic characterisation of porcine B cells is ongoing, with recent advances in the identification of B1 cell subsets and plasma cells. However, regulatory B cells, commonly identified by interleukin (IL)-10 production, have not been studied in pigs so far. Here we investigate IL-10 expression in B cell subsets in response to CpG-oligodeoxynucleotides, phorbol 12-myristate 13-acetate and ionomycin stimulation in vitro. Our results reflect similar findings in human and mice. We identify a small subset of IL-10 competent B cells, present within both porcine B1 and B2 cell subsets across blood, spleen, mediastinal lymph nodes and lung tissue, with varied differentiation statuses. The capacity for IL-10 production coincided with CD95 expression, suggesting an activated phenotype of IL-10 competent B cells. These findings support the emerging paradigm that B cell IL-10 production is a function of various B cell subsets influenced by activation history and microenvironmental factors.
Topics: Animals; B-Lymphocytes, Regulatory; Cell Differentiation; Humans; Interleukin-10; Mice; Swine
PubMed: 35777534
DOI: 10.1016/j.dci.2022.104488 -
The Annals of Thoracic Surgery Aug 2020Cystic thymoma is a rare clinicopathologic entity. Chronic inflammation within and around these tumors has been suggested to compromise the vascular supply, leading to...
Cystic thymoma is a rare clinicopathologic entity. Chronic inflammation within and around these tumors has been suggested to compromise the vascular supply, leading to hemorrhage into the lesion and necrosis. This can result in rapid expansion of the tumor and symptoms owing to local compression. We present the case of a patient with a biopsy-proven lymphocytic-predominant thymoma who underwent resection to reveal a hemorrhagic, necrotic mediastinal cyst adjacent to a focus of organizing pneumonia, with no residual thymoma.
Topics: Aged; Humans; Male; Mediastinal Cyst; Thymoma; Thymus Neoplasms
PubMed: 31987824
DOI: 10.1016/j.athoracsur.2019.12.021 -
The Annals of Thoracic Surgery Feb 2023Angiomyolipomas are benign mesenchymal tumors classified as PEComas, consisting of blood vessels, smooth muscle, and fat, and generally found in renal tissue. Extrarenal...
Angiomyolipomas are benign mesenchymal tumors classified as PEComas, consisting of blood vessels, smooth muscle, and fat, and generally found in renal tissue. Extrarenal cases are uncommon, and those of the mediastinum are rare, with only 23 reports in the literature. We present a successful surgically managed case of a symptomatic 44-year-old woman with a large heart-shaped mediastinal angiomyolipoma in the right hemithorax associated with chylopericardium.
Topics: Female; Humans; Adult; Angiomyolipoma; Mediastinum; Pericardial Effusion; Hamartoma; Kidney Neoplasms
PubMed: 35314157
DOI: 10.1016/j.athoracsur.2022.03.006 -
Surgical Endoscopy Oct 2023Mediastinoscope-assisted transhiatal esophagectomy (MATHE) is the most minimally invasive esophagectomy procedure. It is a more challenging procedure and more difficult...
BACKGROUND
Mediastinoscope-assisted transhiatal esophagectomy (MATHE) is the most minimally invasive esophagectomy procedure. It is a more challenging procedure and more difficult to be popularized than thoracoscopic surgery. We developed a new MATHE operation mode that provides a clearer visual field and makes the procedures simpler.
METHODS
A total of 80 patients with esophageal cancer were divided into a control group (n = 29) and a study group (n = 51). The control group underwent classic MATHE, while the study group received modified MATHE. We compared the two groups on operation time; intraoperative blood loss; blood transfusion amount; incidence rate of lung infection, recurrent laryngeal nerves (RLNs) injury, chylothorax, and anastomotic leakage; and upper mediastinal lymph node dissection.
RESULTS
The study group was significantly better than the control group in operation time (271.78 min vs. 322.90 min, p < 0.05), intraoperative blood loss (48.63 mL vs. 68.97 mL, p < 0.05), and left paratracheal lymph node (No. 4L) dissection rate (88.24% vs. 24.14%, p < 0.01). No significant differences were identified in the incidence rate of anastomotic leakage, lung complications, or RLNs injury between the two groups.
CONCLUSION
The modified MATHE is easier to perform. Modified MATHE is significantly superior to classic MATHE in operation time, intraoperative blood loss, and upper mediastinal lymph node dissection rate.
Topics: Humans; Mediastinoscopes; Anastomotic Leak; Esophagectomy; Blood Loss, Surgical; Retrospective Studies; Lymph Node Excision; Esophageal Neoplasms; Postoperative Complications
PubMed: 37644153
DOI: 10.1007/s00464-023-10341-1 -
BMC Endocrine Disorders Jun 2023Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal... (Review)
Review
BACKGROUND
Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal PC and conduct a related literature review.
CASE PRESENTATION
We described a case of a 50-year-old female patient with PHPT due to mediastinal PC. She was initially admitted to a local hospital in her hometown with hypercalcemia and high blood concentrations of PTH (parathyroid hormone). The patient underwent neck parathyroidectomy and pathological examination suggested parathyroid adenoma. Although the overproduction of serum calcium and PTH declined after the surgery, calcium and PTH increased again one month later, so the patient was transferred to our hospital. A 99Tc-sestamibi scan revealed an ectopic finding in the mediastinum, which was also indicated on the CT image. After removing the mediastinal mass, the metabolism of calcium and PTH quickly reverted to normal and the pathologic features of the mass were consistent with PC. By reviewing the related literature, we noticed that only scattered reports were published before 1982, and those were not included in the present review due to their differences with current radiological examination and treatment methods. After excluding outdated studies, we summarized and analyzed 20 reports of isolated mediastinal PC and concluded that. Parathyroidectomy remains the only curative treatment for the disease. Furthermore, the success of treatment directly depends on accurate preoperative localization.
CONCLUSION
With this study, we emphasize the importance of accurate preoperative diagnosis of mediastinal PC and improve clinicians' understanding of the disease.
Topics: Humans; Female; Middle Aged; Parathyroid Neoplasms; Mediastinum; Calcium; Parathyroid Hormone; Parathyroidectomy; Hyperparathyroidism, Primary
PubMed: 37280629
DOI: 10.1186/s12902-023-01363-w -
JPRAS Open Jun 2021Cancer defects requiring anterior mediastinal tracheostomy (AMT) are complex, often accompanied by tracheo-laryngeal and pharyngeal defects with exposure of the great...
BACKGROUND
Cancer defects requiring anterior mediastinal tracheostomy (AMT) are complex, often accompanied by tracheo-laryngeal and pharyngeal defects with exposure of the great vessels and mediastinal cavity. The trachea has to be mobilised and exteriorised as an end-tracheostome through the anterior chest. A well-vascularised flap that can resurface skin defects, obliterate dead space and allow maturation of a reliable anterior mediastinal tracheostome is required. We describe a modification of using a centrally fenestrated bipedicled chimeric anterolateral thigh flap (ALT) to address these challenges.
METHODS
A free chimeric bipedicled ALT flap was designed. The skin defect was resurfaced by a vertically-oriented skin paddle. Two chimeric muscle components were used to partition the mediastinum and the great vessels of the neck from the tracheostome. The mediastinal trachea was mobilised and matured through a centrally-fenestrated opening in the flap. Layered fascial sutures were employed to minimize dehiscence.
RESULTS/COMPLICATIONS
Two patients with AMT underwent the modified ALT. No major complications such as flap-tracheostomy dehiscence occurred. One patient had a small peripheral demarcation of the flap which required revision and secondary closure.
CONCLUSION
The bipedicled design of the modified ALT flap provided robust blood supply to the central fenestration through dual perforators, avoiding flap-tracheostomy separation. The chimeric muscle components obliterate dead space and protect the great vessels of the neck and mediastinum. The thin pliable nature of the anterolateral thigh skin also allowed for tensionless inset of the trachea.
PubMed: 33614880
DOI: 10.1016/j.jpra.2021.01.007 -
Cell Reports Oct 2023The current paradigm indicates that naive T cells are primed in secondary lymphoid organs. Here, we present evidence that intranasal administration of peptide antigens...
The current paradigm indicates that naive T cells are primed in secondary lymphoid organs. Here, we present evidence that intranasal administration of peptide antigens appended to nanofibers primes naive CD8 T cells in the lung independently and prior to priming in the draining mediastinal lymph node (MLN). Notably, comparable accumulation and transcriptomic responses of CD8 T cells in lung and MLN are observed in both Batf3KO and wild-type (WT) mice, indicating that, while cDC1 dendritic cells (DCs) are the major subset for cross-presentation, cDC2 DCs alone are capable of cross-priming CD8 T cells both in the lung and draining MLN. Transcription analyses reveal distinct transcriptional responses in lung cDC1 and cDC2 to intranasal nanofiber immunization. However, both DC subsets acquire shared transcriptional responses upon migration into the lymph node, thus uncovering a stepwise activation process of cDC1 and cDC2 toward their ability to cross-prime effector and functional memory CD8 T cell responses.
Topics: Mice; Animals; CD8-Positive T-Lymphocytes; Dendritic Cells; Lung; Cross-Priming; Lymph Nodes
PubMed: 37864794
DOI: 10.1016/j.celrep.2023.113299 -
Seminars in Thoracic and Cardiovascular... 2019Compared to the intercostal approach, subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) is considered to be less invasive as it may cause minimal...
Compared to the intercostal approach, subxiphoid uniportal video-assisted thoracoscopic surgery (VATS) is considered to be less invasive as it may cause minimal postoperative pain. Besides, it provides an excellent view of the bilateral pleural cavities. In this paper, we describe our technique and overview a 2-year experience results in this approach for the surgical treatment of anterior mediastinal and pulmonary lesions. In a retrospective study of data collected prospectively between October 2014 and December 2016, 38 patients underwent surgery for an anterior mediastinal tumor or myasthenia gravis at our institution. Intraoperative factors like duration of operation and amount of blood loss were analyzed as well as postoperative ones, including duration of chest drains, amount of postoperative fluid drainage, and length of hospital stay. The median age of patients was 59 years (36-80 years) with 19 females (50%). Overall, 28 patients (74%) underwent extended thymectomy. Seven patients (19%) experienced a combined lung resection and extended thymectomy, 3 (7%) a resection of pericardial (2) or bronchogenic (1) cysts. The median diameter of the lesions was 2.93 cm (1.2-7.7 cm). Postoperatively, 30-day mortality was 0%. Subxiphoid uniportal VATS is a convenient approach for minimally invasive mediastinal surgery. The excellent exposure of the anterior mediastinum and the possibility of conducting complex procedures, such as extended thymectomies and combined mediastinal and pulmonary resections with good results of minimal morbidity, represent the strong points of this technique. Thoracic surgeons experienced in VATS can safely perform subxiphoid uniportal VATS for mediastinal surgery.
Topics: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Databases, Factual; Female; Humans; Male; Middle Aged; Myasthenia Gravis; Operative Time; Pneumonectomy; Postoperative Complications; Retrospective Studies; Risk Factors; Thoracic Neoplasms; Thoracic Surgery, Video-Assisted; Thymectomy; Time Factors; Treatment Outcome
PubMed: 30796955
DOI: 10.1053/j.semtcvs.2019.02.016 -
Allergy Jul 2023Pulmonary eosinophils comprise at least two distinct populations of resident eosinophils (rEOS) and inflammatory eosinophils (iEOS), the latter recruited in response to...
BACKGROUND
Pulmonary eosinophils comprise at least two distinct populations of resident eosinophils (rEOS) and inflammatory eosinophils (iEOS), the latter recruited in response to pulmonary inflammation. Here, we determined the impact of complement activation on rEOS and iEOS trafficking and function in two models of pulmonary inflammation.
METHODS
BALB/c wild-type and C5ar1 mice were exposed to different allergens or IL-33. Eosinophil populations in the airways, lung, or mediastinal lymph nodes (mLN) were characterized by FACS or immunohistochemistry. rEOS and iEOS functions were determined in vivo and in vitro.
RESULTS
HDM and IL-33 exposure induced a strong accumulation of iEOS but not rEOS in the airways, lungs, and mLNs. rEOS and iEOS expressed C3/C5 and C5aR1, which were significantly higher in iEOS. Initial pulmonary trafficking of iEOS was markedly reduced in C5ar1 mice and associated with less IL-5 production from ILC2 cells. Functionally, adoptively transferred pulmonary iEOS from WT but not from C5ar1 mice-induced airway hyperresponsiveness (AHR), which was associated with significantly reduced C5ar1 iEOS degranulation. Pulmonary iEOS but not rEOS were frequently associated with T cells in lung tissue. After HDM or IL-33 exposure, iEOS but not rEOS were found in mLNs, which were significantly reduced in C5ar1 mice. C5ar1 iEOS expressed less costimulatory molecules, associated with a decreased potency to drive antigen-specific T cell proliferation and differentiation into memory T cells.
CONCLUSIONS
We uncovered novel roles for C5aR1 in iEOS trafficking and activation, which affects key aspects of allergic inflammation such as AHR, ILC2, and T cell activation.
Topics: Mice; Animals; Eosinophils; Interleukin-33; Immunity, Innate; Lymphocytes; Asthma; Lung
PubMed: 36757006
DOI: 10.1111/all.15670 -
Chest Sep 2021A 74-year-old man, in excellent physical condition and doing regular intense cycling, was evaluated for transient episodes of thoracic discomfort over a period of...
A 74-year-old man, in excellent physical condition and doing regular intense cycling, was evaluated for transient episodes of thoracic discomfort over a period of several months. His medical history only included a right inguinal hernia, surgically treated, and an abdominal aortic aneurysm measured at 46 mm and treated medically. Physical examination did not reveal much information. The patient did not report gastroesophageal reflux, dysphagia, or history of digestive occlusion. The patient had normal weight and had no trauma history. He had no nicotine or alcohol-dependent behaviors. Vital signs were within normal values. Laboratory test results were normal. Functional status was normal, without anomalies of pulmonary function tests or arterial blood gases. The ECG did not reveal any anomaly.
Topics: Abdominal Cavity; Aged; Chest Pain; Colon; Diagnosis, Differential; Hernias, Diaphragmatic, Congenital; Herniorrhaphy; Humans; Laparotomy; Male; Mediastinum; Radiography, Thoracic; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 34488972
DOI: 10.1016/j.chest.2021.04.021