Ischaemic spinal cord injury (SCI) remains the Achilles heel of open and endovascular descending thoracic and thoracoabdominal repair. Neurological outcomes have improved coincidentially with the introduction of neuroprotective measures. However, SCI (paraplegia and paraparesis) remains the most devastating complication. The aim of this position paper is to provide physicians with broad information regarding spinal cord blood supply, to share strategies for shortening intraprocedural spinal cord ischaemia and to increase spinal cord tolerance to transitory ischaemia through detection of ischaemia and augmentation of spinal cord blood perfusion. This study is meant to support physicians caring for patients in need of any kind of thoracic or thoracoabdominal aortic repair in decision-making algorithms in order to understand, prevent or reverse ischaemic SCI. Information has been extracted from focused publications available in the PubMed database, which are cohort studies, experimental research reports, case reports, reviews, short series and meta-analyses. Individual chapters of this position paper were assigned and after delivery harmonized by Christian D. Etz, Ernst Weigang and Martin Czerny. Consequently, further writing assignments were distributed within the group and delivered in August 2014. The final version was submitted to the EJCTS for review in September 2014.

Seasonal viruses present a major cause of morbidity and mortality in temperate climates. Through major pandemics and smaller annual epidemics, viruses such as infl uenza, respiratory syncytial virus (RSV) and human rhinovirus (HRV) result in lost school and work days for most that are infected and more serious complications for the immunocompromised. The reasons for these viruses showing strict seasonality include but are not limited to the infl uence of cold weather and humidity on virus particles, human physiology, and human behavior. The relative importance of each is dependent on what geographic scale is being explored as well as the individual region and time period. Theoretical mathematics has also revealed that climatic changes are likely not the only reasons for strong seasonal cycles, but these are also based in periodic resonance with the natural cycles of immunity and antigenic variance, as well as nationwide synchrony through transportation networks. Investigations of seasonality will aid in understanding disease transmission, and thereby effective prevention strategies. The authors present a review of the literature on seasonal viruses, their annual diffusion through populations, and factors that reduce or enhance their seasonal spread. They also offer suggestions for targeted interventions to reduce the disease burden from seasonal viruses. Clin Trans Sci 2011; Volume 4: 48-54

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Follicular dendritic cell (FDC) sarcoma is a very rare neoplasm showing morphologic and phenotypic features of FDCs. It occurs primarily in lymph nodes but also in extranodal sites. So far, there have been no reports on FDC sarcoma associated with myasthenia gravis. In the following we will present a case of an FDC tumor of the mediastinum associated with paraneoplastic myasthenia gravis in a 39-year-old man. The tumor contained a major proportion of immature T cells, which may be connected to this patient's very unusual clinical presentation with autoimmune phenomena. Extranodal FDC sarcomas still seem hardly noticed, and their clinical and pathologic characteristics remain to be better defined.

Seamless integration of the various components of treatment will be essential for further improvements in outcome. In particular, the follow-up care of transplant recipients should always be provided in close cooperation with the transplant center.