A chest surgeon can have a high success rate in videothoracoscopic thymectomy (98%) after 60 operations.

IntroductionAutopsy series have shown that metastasis to the thyroid gland has occurred in up to 24% of patients who have died of cancer. Neuroendocrine tumors may metastasize to thyroid gland.Case presentationsCase 1 was a 17-year-old Turkish woman who was referred from our Endocrinology Department for a thyroidectomy for treatment of neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination results were consistent with a neuroendocrine tumor; neoplastic cells showed strong immunoreactivity to chromogranin A and synaptophysin, but the immunohistochemical profile was inconsistent with medullary thyroid carcinoma in that the tumor was negative for calcitonin, carcinoembryonic antigen, and thyroid transcription factor-1.Case 2 was a 54-year-old Turkish woman who presented with a 3-cm nodule on her right thyroid lobe. She had undergone surgery for a right lung mass four years previously. After a right pneumonectomy, thymectomy and lymph node dissection, a typical carcinoid tumor was diagnosed. Under ultrasonographic guidance, fine needle aspiration biopsy of her right thyroid pole nodule was performed and the biopsy was compatible with a neuroendocrine tumor metastasis. She was treated with a bilateral total thyroidectomy. Histopathological examination indicated three nodular lesions, 5 cm and 0.4 cm in diameter in her right lobe and 0.1 cm in diameter in her left lobe. The tumors were consistent with a neuroendocrine phenotype, showing strong immunoreactivity to chromogranin A and synaptophysin.ConclusionThyroid nodules detected during follow-up of neuroendocrine tumor patients should be thoroughly investigated. A fine needle aspiration biopsy of the thyroid confirms the diagnosis in most cases and leads to appropriate management of those patients and may prevent unnecessary treatment approaches.

ÖZAmaç: Bu deneysel çalışmada, doğal bir flavonoid olan hesperetinin sıçanlarda lipopolisakkarit uyarımlı akut akciğer hasar modeli üzerindeki etkileri incelendi. Ça lış m a pl a nı:Mart 2019 -Mayıs 2019 tarihleri arasında ağırlıkları yaklaşık 250-300 g olan toplam 18 erişkin erkek Wistar albino sıçan, kontrol, lipopolisakkarit ve lipopolisakkarit + hesperetin grubu olmak üzere rastgele üç gruba ayrıldı (her grupta n= 6). Akciğer dokusunda ıslak/kuru ağırlık oranı belirlendi. Histopatolojik değişiklikler ışık ve elektron mikroskobu ile incelendi. Pulmoner nükleer faktör-kappa beta, indüklenebilir nitrik oksit sentaz ve alfa-düz kas antijeni indirekt immünohistokimyasal yöntem ile belirlendi. Pulmoner apoptoz, terminal deoksinükleotidil transferaz dUTP çentik uç işaretleme yöntemi ile belirlendi. Tümör nekroz faktör-alfa, interlökin-1 beta, interlökin-6 ve interlökin-10 konsantrasyonları enzim bağlı immunosorbent testi ile belirlendi. Bul gu lar:Hesperetin tedavisi akciğer doku mimarisini anlamlı düzeyde iyileştirdi ve ıslak/kuru ağırlık oranı, nükleer faktör-kappa beta, indüklenebilir nitrik oksit sentaz ve alfa-düz kas antijeni ekspresyonu, pulmoner apoptoz ve proinflamatuvar sitokin düzeylerini azalttı.So nuç: Çalışma sonuçlarımız, hesperetinin sıçanlarda proinflamatuvar sitokin kaskadı, nükleer faktör-kappa beta sinyal yolağı aktivasyonu ve apoptozun baskılanması ile lipopolisakkarit uyarımlı akut akciğer hasarına karşı güçlü bir koruyucu etkiye sahip olduğunu göstermektedir.Anah tar söz cük ler: Akut akciğer hasarı, indüklenebilir nitrik oksit sentaz, lipopolisakkarit, nükleer faktör-kappa beta, pulmoner apoptoz, tümör nekroz faktör-alfa. ABSTRACTBackground: In this experimental study, we aimed to investigate the effects of hesperetin, a natural flavonoid, on a lipopolysaccharideinduced acute lung injury model in rats. Methods:Between March 2019 and May 2019, a total of 18 adult male Wistar albino rats, weighing approximately 250 to 300 g, were randomly divided into three groups as control, lipopolysaccharide, and lipopolysaccharide + hesperetin groups (n=6 in each group). The wet/dry weight ratio of lung tissue was determined. Histopathological changes were examined using light and scanning electron microscopy. Pulmonary nuclear factor-kappa beta, inducible nitric oxide synthase, and alpha-smooth muscle antigen activity were determined with indirect immunohistochemical methods. Pulmonary apoptosis was detected with the terminal deoxynucleotidyl transferase dUTP nick-end labeling method. Tumor necrosis factor-alpha, interleukin-1 beta, interleukin-6, and interleukin-10 concentrations were measured with enzyme-linked immunosorbent assay.Results: Treatment with hesperetin significantly improved the architecture of lung tissue and reduced the wet/dry weight ratio, nuclear factor-kappa beta, inducible nitric oxide synthase, and alphasmooth muscle antigen expression, pulmonary apoptosis, and levels of proinflammatory cytokines. Conclusion:Our study results suggest that hesperetin has a potent protective effect aga...

A cytological diagnosis is essential for a definitive diagnosis in children who have paratracheal lesions. Thirteen pediatric patients were biopsied using cervical mediastinoscopy. Age, gender, preoperative diagnosis, and postoperative biopsy results and complications were reviewed. Five patients had mediastinal lesions residuing or recurring after chemotherapy for either Hodgkin disease or non-Hodgkin lymphoma. In 2 of these patients, the diagnosis was recurrent disease. Among the 8 patients presenting with a paratracheal mass or enlarged lymph nodes, histopathologic diagnosis showed tuberculosis in 3 children, Hodgkin disease in 2 children, and histiocytosis X and non-Hodgkin lymphoma 1 patient in each. This study shows that cervical mediastinoscopy gave 100% correct diagnosis for mediastinal residual malignancies or uncommon forms of mycobacterium tuberculosis with paratracheal masses.

Transcaval extension of the thymoma to the right atrium has very rarely been reported, and cardiopulmonary bypass is recommended for successful resection. An invasive thymoma with intravascular invasion of the superior vena cava, and the left innominate vein extending into the right atrium was presented. Intra-atrial extension was resected through a transient external shunt from the inferior vena cava to the main pulmonary artery. We discussed the feasibility of this surgical technique and possible advantages of cardiopulmonary bypass avoidance.