169,743 research outputs found
Ultra high pressure metamorphism in felsic rocks: the garnet – phengite gneisses and quartzites from Lanterman Range (Antarctica)
No full textMesostructural and microstructural relations between eclogitic boudins and country gneisses in the Ross Orogen of the Lanterman Range (Northern Victoria Land, Antarctica) are in some areas characterized by interlayering with sharp contacts on a cm scale, which indicate that the two rock-types underwent a common metamorphic evolution. Contrary to many other UHP felsic rocks that only preserve a poor record of the HP stage, the studied rocks have recorded a metamorphic history ranging from initial prograde amphibolite facies through the eclogite facies to the retrogressive amphibolite facies. The prograde amphibolite stage is documented by garnet relics preserving prograde zoning and bearing biotite, plagioclase, muscovite, phengite and rutile inclusions. The eclogite stage is characterized by the coexistence of phengite with pyrope-grossularite rich garnet, the latter containing phengite and paragonite inclusions, and by radial fractures within garnet around quartz pseudomorphs after coesite. Symplectites have formed during the amphibolite-facies retrogression. They consist mainly of biotite + plagioclase around phengite and garnet; muscovite, biotite and plagioclase grew along the main foliation. The reconstructed metamorphic evolution, involves a steep prograde and retrograde PT path as well as a HP-T peak. Along with the geochronological evidence of fast exhumation, this supports a model of arc-continent collision, with the HP rocks belonging to the over-riding plate. Their exhumation is mainly controlled by extension related to renewed "rollback" of subduction in front of the orogenic zone
Pattern of recurrence and survival of c-Ia NSCLC diagnosed by transpleural methods
No full textAim. The aim of this study was to evaluate if transpleural diagnostic methods as percutaneous fineneedle aspiration biopsy (FNAB) or tumour wedge resection by video-assisted thoracoscopic surgery (VATS) impact on local recurrence and long term survival of patients affected by non-small cell lung cancer (NSCLC). Methods. Records concerning 179 patients with peripheral c-Ia NSCLC who underwent complete resection from 1994 to 2000 have been reviewed. Patients were randomized into two groups according to the diagnostic method employed, as follows: in group I (N.=63) diagnosis was obtained by bronchoscopy; in group II (N.=116) diagnosis was obtained by FNAB (N.=59) or tumour wedge resection by VATS (N.=57) after a negative bronchoscopy. Survival curves were compared using log-rank test. Distribution of frequencies was analyzed with Chi-square and Fisher's exact test. Results. The two groups of patients did not significantly differ in terms of age, gender, forced expiratory volume in 1 second, comorbidities, histological type and tumour size; pathologic stage IIb was more frequent in group I. At a median follow-up of 48 months, (range 2-108 months), local recurrence was found in 9.5% (N.=6) of the patients in group I and in 12.5% (N.=15) of patients in group II (P=NS); distant metastasis were found in 28.6% (N.=18) of patients in group I and in 13.8% (N.=16) in group II (P=0.03). Patients in group II had a statistically better five-year survival rate than patients in group I (70% and 55% respectively P=0.016). Conclusion. FNAB and tumour wedge resection by VATS represent valuable diagnostic methods for lung cancers, since they do not seem to increase the risk of local recurrence. On the other hand, tumours diagnosed by bronchoscopy have a worse prognosis, that may be related to their higher metastatic potential rather than to diagnostic procedure itself
Ultrahigh-pressure metamorphism and exhumation of garnet-bearing ultramafic rocks from the Lanterman Range (northern Victoria Land, Antarctica)
No full textNorthern Victoria Land is a key area for the Ross Orogen – a Palaeozoic foldbelt formed at the palaeo-Pacific margin of Gondwana. A narrow and discontinuous high- to ultrahigh-pressure (UHP) belt, consisting of mafic and ultramafic rocks (including garnet-bearing types) within a metasedimentary sequence of gneisses and quartzites, is exposed at the Lanterman Range (northern Victoria Land). Garnet-bearing ultramafic rocks evolved through at least six metamorphic stages. Stage 1 is defined by medium-grained garnet + olivine + low-Al orthopyroxene + clinopyroxene, whereas finer-grained garnet + olivine + orthopyroxene + clinopyroxene + amphibole constitutes the stage 2 assemblage. Stage 3 is defined by kelyphites of orthopyroxene + clinopyroxene + spinel ± amphibole around garnet. Porphyroblasts of amphibole replacing garnet and clinopyroxene characterize stage 4. Retrograde stages 5 and 6 consist of tremolite + Mg-chlorite ± serpentine ± talc. A high-temperature (∼950 °C), spinel-bearing protolith (stage 0), is identified on the basis of orthopyroxene + clinopyroxene + olivine + spinel + amphibole inclusions within stage 1 garnet. The P–T estimates for stage 1 are indicative of UHP conditions (3.2–3.3 GPa and 764–820 °C), whereas stage 2 is constrained between 726–788 °C and 2.6–2.9 GPa. Stage 3 records a decompression up to 1.1–1.3 GPa at 705–776 °C. Stages 4, 5 and 6 reflect uplift and cooling, the final estimates yielding values below 0.5 GPa at 300–400 °C. The retrograde P–T path is nearly isothermal from UHP conditions up to deep crustal levels, and becomes a cooling–unloading path from intermediate to shallow levels. The garnet-bearing ultramafic rocks originated in the mantle wedge and were probably incorporated into the subduction zone with felsic and mafic rocks with which they shared the subsequent metamorphic and geodynamic evolution. The density and rheology of the subducted rocks are compatible with detachment of slices along the subduction channel and gravity-driven exhumation
Lung cancer with chest wall involvement: Predictive factors of long-term survival after surgical resection
No full textMultimodal management of lung cancer extending to chest wall and type of surgical procedure to be performed are still debated. The aim of this retrospective analysis was to analyze the predictive factors of long-term survival after surgery, focusing on depth of infiltration, type of surgical intervention and possible role of preoperative therapies, comparing survival of these patients with that of a group of patients affected by a Pancoast tumour and surgical treated in the same period. Materials and methods: We reviewed records of 83 consecutive patients with NSCLC in stage T3 (owing to direct extension to chest wall), who underwent surgical resection in our Thoracic Surgery Unit between January 1994 and December 2003. Patients were classified in two groups: pancoast tumours (PT) or chest wall extending tumours (CW): survival and prognostic factors of each category were analyzed. Results: In the CW group we had 68 patients: 45 were in stage IIB (pT3N0), 23 in stage IIIA (pT3-N1-2). Histology revealed adenocarcinoma in 23 cases, squamous cell carcinoma in 34, large cells anaplastic carcinoma in 8, adenosquamous carcinoma in 3. An involvement of chest wall tissues beyond the endothoracic fascia was found in 21 patients, while in the remaining 47 the invasion of chest wall tissues was confined to the parietal pleura. An extrapleural dissection was performed in 48 patients while combined pulmonary and chest wall en bloc resection was required in 20 patients. Resection was incomplete in three cases. In the PT group we had 15 patients: 11 were in stage IIB and 4 in stage IIIA. Histological type was adenocarcinoma in 10 cases, squamous cell carcinoma in 4 and adenosquamous carcinoma in 1. A univariate analysis performed in the CW group showed that survival was significantly affected by nodal status, stage, extension of chest wall invasion, type of lung resection and residual disease. In a multivariate analysis we found that nodal status, completeness of resection and extension of chest wall involvement maintained a significant prognostic value. There was no difference between the survival curve of CW and PT group: considering the two subset of CW patients, on the basis of depth of infiltration, survival of PT patients was significantly better than that of CW patients with involvement of muscular tissues and ribs (p = 0.02). Conclusion: Nodal status, radical resection and depth of chest wall infiltration are the main predictive factors affecting long-term survival, while surgical procedure does not impact on it if margins of resection are free from disease. The better survival observed in PT patients let us to hypothesize that an induction chemo-radiation therapy, as routinely administered to PT patients, could have a potential benefit in survival of patients with CW tumour extending beyond parietal pleura. © 2006 Elsevier Ireland Ltd. All rights reserved
Correction to: Lung cancer and interstitial lung diseases: the lack of prognostic impact of lung cancer in IPF (Internal and Emergency Medicine, (2022), 17, 2, (457-464), 10.1007/s11739-021-02833-6)
No full textThe caption of Fig. 1 shown in the article is incomplete, the correct caption is shown below: “Fig. 1 a Correlation between interval time ‘LC diagnosis and follow up end’ and DLCO% in the three groups: UIP/IPF-LC (blue circles), SR-ILD-LC (green circles), O-ILD-LC (red circles). b Localization of lung cancer in the three groups: UIP/IPF-LC, SR-ILD-LC, O-ILD-LC. Blue columns: central cancer not in fibrotic area; green columns: peripheral cancer not in fibrotic area; beige columns: peripheral cancer in fibrotic area. c Survival in the three groups of patients: UIP/IPF-LC, SR-ILD-LC, O-ILD-LC. d Survival in patients with UIP/IPF with and without lung cancer (LC)”
Lung resection for Non Small Cell Lung Cancer after prophylactic coronary angioplasty and stenting: short and long-term results.
No full textAim: Recent studies have reported a high incidence of perioperative in-stent trombosis with myocardial infarction (MI), in patients undergoing non-cardiac surgery, early after coronary angioplasty and stenting. The short and long-term results of surgery for nonsmall cell lung cancer (NSCLC) after prophylatic coronary angioplasty and stenting were analyzed. Methods: Prospective collected data were examined for postoperative complications and long-term survival in 16 consecutive patients who underwent mayor lung resection for NSCLC after prophylactic coronary angioplasty and stenting for significant coronary artery disease, from 2001 to 2008. One and two non-drug-eluting stents were placed in 75% or (25% of the patient, respectively. All patients had four weeks of dual antiplatelet therapy, that was discontinued 5 days prior to surgery and replaced by low molecular weight heparin. Patients were keep sedated and intubated overnight, according to our protocol. Results: There were no postoperative deaths nor MI. A patient experienced pulmonary embolism with moderate troponin release and underwent coronary angiography that showed patency of the stent. Two patients developed postoperative bleeding complications haemothorax requiring a re-thoracotomy in 1, gastric bleeding requiring blood transfusion in 1. At the mean follow-up of 30 months (range 3-95), none of the patients showed evidence of myocardial ischemia, while 5 (31%) patients died, mostly (N.=4) due to distant metastasis. The five-year survival rate was 53%. Conclusion: In contrast to previous reports, lung resection after prophylactic coronary angioplasty and stenting is a safe and effective treatment for NSCLC and myocardial ischemia. The application of a refined protocol could be the key factor for improved results
Abscess of residual lobe after pulmonary resection for lung cancer
No full text: Abscess of the residual lobe after lobectomy is a rare but potentially lethal complication. Between January 1975 and December 2006, 1,460 patients underwent elective pulmonary lobectomy for non-small-cell lung cancer at our institution. Abscess of the residual lung parenchyma occurred in 5 (0.3%) cases (4 bilobectomies and 1 lobectomy). Postoperative chest radiography showed incomplete expansion and consolidation of residual lung parenchyma. Flexible bronchoscopy revealed persistent bronchial occlusion from purulent secretions and/or bronchial collapse. Computed tomography in 3 patients demonstrated lung abscess foci. Surgical treatment included completion right pneumonectomy in 3 patients and a middle lobectomy in one. Complications after repeat thoracotomy comprised contralateral pneumonia and sepsis in 1 patient. Residual lobar abscess after lobectomy should be suspected in patients presenting with fever, leukocytosis, bronchial obstruction and lung consolidation despite antibiotic therapy, physiotherapy and bronchoscopy. Computed tomography is mandatory for early diagnosis. Surgical resection of the affected lobe is recommended
Iterative surgical resection for local recurrent and second primary bronchogenic carcinoma
No full textObjective: To report our experience with repeated pulmonary resection in patients with local recurrent and second primary bronchogenic carcinoma, to assess operative mortality and late outcome. Methods: The medical records of all patients who underwent a second lung resection for local recurrent and second primary bronchogenic carcinoma from 1978 through 1998 were reviewed. Results: There were 27 patients. They constituted 2.5% of 1059 patients who had undergone lung resection for bronchogenic carcinoma in the same period. Twelve patients (1.1%) (group 1) had a local recurrence that developed at a median interval of 24 months (range 4-83).The first pulmonary resection was lobectomy in ten patients and segmentectomy in two. The second operation consisted of completion pneumonectomy in ten cases, completion lobectomy in one and wedge resection of the right lower lobe after a right upper lobectomy in one. The other 15 patients (1.4%) (group 2) had a new primary lung cancer that developed at a median interval of 45 months (range 21-188).The first pulmonary resection was lobectomy in 12 patients, bilobectomy in one and pneumonectomy in two. The second pulmonary resection was controlateral lobectomy in seven patients, controlateral sleeve lobectomy in two, controlateral pneumonectomy in 1, controlateral wedge resection in four and completion pneumonectomy in one. Overall hospital mortality was 7.4%, including one intraoperative and one postoperative death in group 1 and 2, respectively. Five-year survival after the second operation was 15.5 and 43% with a median survival of 26 and 49 months in groups 1 and 2, respectively (P=ns). Conclusions: Long-term results justify complete work-up of patients with local recurrent and second primary bronchogenic carcinoma. Treatment should be surgical, if there is no evidence of distant metastasis and the patients are in good health. Early detection of second lesions is possible with an aggressive follow-up conducted maximally at 4 months intervals for the first 2 years and 6 months intervals thereafter throughout life. Copyright (C) 2000 Elsevier Science B.V
Neoadjuvant chemotherapy for Non-Small-Cell lung cancer: Does it really impact on postoperative outcome after lung resection?
No full textBACKGROUND Although some studies seem to indicate a positive prognostic value of induction chemotherapy in patients with locally advanced Non-Small-Cell Lung Cancer (NSCLC), its impact on postoperative mortality and morbidity is not well established. MATERIALS AND METHODS We reviewed the records of 83 consecutive patients who underwent thoracotomy after induction therapy between 1996 and 2007 (Group 1). Results were compared to those of a control group of 166 patients surgically treated in the same period without prior neoadjuvant therapy (Group 2). RESULTS The two groups were matched for age, sex, histology, comorbidity, respiratory function, and surgical procedure. There was no hospital mortality. Cumulative incidence of major complications was 32% in Group 1 and 37% in Group 2 (p=0.18). The incidence of each complication considered did not significantly differ between the two groups. A higher percentage of patients in Group 1 required blood transfusions (21.7% vs 4.2%, p<0.0001). Multiple logistic regression analysis showed forced expiratory volume in 1 s (FEV1)<75% of predicted (p=0.018) and blood transfusions (p=0.006) to be independent risk factors for major postoperative events in Group 1. DISCUSSION Preoperative chemotherapy did not seem to affect overall morbidity and mortality. Patients with a FEV1B75% of predicted or requiring blood transfusions resulted at increased risk of developing major complications
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