Depertmem of Tho rack and Cardio vasc ular Sergery.H ecette pe Unlversny, Facu lly of~ed iti ne. Anka ra. Turkey 95 Su m mary At the Depa rtm ent of Thoracic a nd Card iovascula r Surgery of Itaeeue po University. a total number of822 pedia tric bronchoscopies were performed from 191' 14 through 1990 for suspected foreign body asp iration . Of the children 65 .3 % were boys and 34,7% were girls ran ging in age from one month to 14 years . Deflnuive state ment of foreign-body aspira tion was obtai ned from 394 patients . Unilateral hyper aeration . atelecta sis. and unilateral parenchymal infiltra tion were the most common radlologtcal flndings. In all end oscopic procedures. a pediatric rigid bronchoscope was use-d under gener al anesthesia a nd controlle-d venulauon . Fore ign bodies were found in 77.7 "10 of the 822 patients. In the rest of the children infla mmatory drsordcrs .....e re confirmed. The foreign bodies most com monly found in 639 patien ts were sun-flower seeds 121 .1%1.beans (10. 4"10). water -melon seeds 110"101. and hazelnu ts 19.8 %1.In our presente-d series. the incidence of non-fatal compllcation was 1.8"10. apa rt from these pat ients 5 cr tbe m (0.6"10) die-d afier the bronchoscopic proce-d ures. Kt') ' we r dsIJronchoscopy -Foreign-body as piration -Endosco py Introdu cuonIn spite of the endoscopic tnves ug a uo n of th e res piratory tract in new bo rns a nd c hild re n having some pote ntial ris k. bronc hosco py is a n im po rta nt diagnosti c a nd the rapeutic tool . Many authors haw regarded aspiration of a for eign body into th e respiratory tract as an important cause of mortality in childre n . Especially small c hild ren. whose ai rways a re narrow and in whom th e protective m echanisms a re inadequate. a re victims u. 13. 14 I.The diagnos is offoretgn-body aspiration in in fa nts and child ren is ofte n d ifficu lt ....-ith no n-bronchoscoplc d iagnostic techniq ues. In spite of modern techniques of radiology such as co mputed to mog ra ph y. m agne tic resonance im agin g. xerora diog raphy. o nly a n e ndosco pic techn ique ca n re veal Thorac. csrcrovesc. Surgeon 39 (199 t I95-98

Syndecan-1 (SDC1, CD138) is a key cell surface adhesion molecule essential for maintaining cell morphology and interaction with the surrounding microenvironment. Deregulation of SDC1 contributes to cancer progression by promoting cell proliferation, metastasis, invasion and angiogenesis, and is associated with relapse through chemoresistance. SDC1 expression level is also associated with responses to chemotherapy and with prognosis in multiple solid and hematological cancers, including multiple myeloma and Hodgkin lymphoma. At the tissue level, the expression levels of SDC1 and the released extracellular domain of SDC1 correlate with tumor malignancy, phenotype, and metastatic potential for both solid and hematological tumors in a tissue-specific manner. The SDC1 expression profile varies among cancer types, but the differential expression signatures between normal and cancer cells in epithelial and stromal compartments are directly associated with aggressiveness of tumors and patient's clinical outcome and survival. Therefore, relevant biomarkers of SDC signaling may be useful for selecting patients that would most likely respond to a particular therapy at the time of diagnosis or perhaps for predicting relapse. In addition, the reciprocal expression signature of SDC between tumor epithelial and stromal compartments may have synergistic value for patient selection and the prediction of clinical outcome.

Extrapleural haematoma (EH) is a rare clinical condition of which four cases are presented. Different etiologies were encountered. Identical findings were found on the chest X-ray. Two cases were secondary to spontaneous rib fracture and the other two were iatrogenic. Surgical exploration was necessary in one patient following pleural biopsy. Medical treatment and clinical observation were the treatment of choice in the remaining three stable patients.

Background: An elastofibroma is a benign, soft-tissue tumor and is important in the differential diagnosis of thoracic wall masses. Here, patients with elastofibromas who underwent thoracic surgery were retrospectively reviewed to elucidate elastofibroma formation and to facilitate the differential diagnosis. Methods: This is a retrospective and descriptive study of a series of 30 patients with elastofibroma dorsi. The data was obtained by review of the hospital records. Results: There were 27 female and three male patients (mean age, 55.13 Ϯ 8.7 years) with a total of 42 elastofibroma dorsi tumors (12 bilateral cases, 18 unilateral cases) diagnosed between January 2004 and October 2011. Twenty patients (67%) underwent surgery as a result of subscapular swelling and pain. In 10 (33%) asymptomatic patients, elastofibromas were found incidentally during a thoracotomy. Imaging methods in symptomatic patients included computerized tomography (15 cases), magnetic resonance (three), and ultrasonography (two). For five patients, fluorodeoxyglucose uptake values were available and revealed mild metabolic activity in the elastofibromas. Elastofibromas were significantly larger in symptomatic patients (8.15 Ϯ 1.9 vs. 6.2 Ϯ 2.3; P = 0.02). Exposure to long-term repetitive micro-trauma was a precipitating factor in 23 (77%) patients. Seroma formation, the most common surgical complication, was observed in 40% of patients. Conclusion: The differential diagnosis of elastofibroma dorsi is straightforward, and preoperative histology is unnecessary when the clinical, radiological, and metabolic characteristics are known. Repetitive micro-trauma may predispose to hyperproliferation of fibroelastic tissue, and genetics may also play a role. Surgical treatment can be reserved for cases with severe symptoms.

Purpose: It is critical to differentiate among pathologies of substernal thyroid gland diseases because surgical approaches (i.e., median sternotomy or thoracotomy) might also include a cervical incision. The aim of this study was to analyze the features of patients with goiter who underwent a thyroidectomy via a cervical incision and a median sternotomy or thoracotomy. Methods: We reviewed 9 cases of thyroid disease in patients undergoing thoracic incisions with or without a cervical incision for varying indications between March 2003 and Jun 2009 were reviewed. Thyroidal masses were removed via a median sternotomy in six patients and thoracotomy in three patients. Split median sternotomy combining thoracotomy was performed in 1 patient. Cervical incision was added in all patients. Results: Pathologic examination revealed multinodular goiter in 5 patients, thyroid carcinoma in 3, and reidel thyroiditis in 1. All patients were extubated in the early postoperative period. There was no postoperative mortality or morbidity. The mean hospital stay was 8.6 days (range, 4-11 days), and mean follow-up was 24.3 months (range, 4-39 months). Conclusions: We recommend the use of transthoracic approaches, such as median sternotomy and thoracotomy for retrosternal goiter for surgical exposure, because they provide a wide exposure and facilitate removal of the mass. By using median sternotomy and thoracotomy, we can avoid catastrophic results, such as hemorrhage, as well as completely remove malignancies.