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“Objective: The aim of this report is to describe technical maneuvers used to complete minimally invasive resections of the chest wall successfully.
Methods: Case videos Pifithrin-�� of advanced thoracoscopic chest wall resections performed at a comprehensive cancer center were reviewed, as were published reports. These were analyzed for similarities and also categorized to summarize alternative approaches.
Results: Limited
chest wall resections en bloc with lobectomy can be accomplished with port placement similar to that used for typical thoracoscopic anatomic resections, particularly when the utility incision is close to the region of excision. Generally, chest wall resection precedes lobectomy. Ribs can be transected with Gigli saws, endoscopic shears, or high-speed drills. Division of bone and overlying soft tissue can be planned precisely using thoracoscopic guidance. Isolated primary chest wall masses may require different port position and selective reconstruction using synthetic materials. Patch anchoring can be accomplished by devices that facilitate laparoscopic port site fascial closure.
Conclusions: Thoracoscopic chest wall resections have
been accomplished safely using PRT062607 in vivo tools and maneuvers summarized here. Further outcomes research is necessary to identify the benefits of thoracoscopic chest wall resection over an open approach. (J Thorac Cardiovasc Surg 2012; 144:S52-7)”
“Throughout life, new neurons arise from the ventricular zone of the adult songbird brain and are recruited to the song control nucleus higher vocal center (HVC), from which they extend projections to its target, nucleus robustus of the arcopallium (RA). This process of ongoing paren-chymal neuronal addition and circuit integration is both triggered and modulated by seasonal surges in systemic testosterone. Brain aromatase converts circulating testosterone to estradiol, so that HVC is concurrently exposed to both androgenic and estrogenic stimulation. These
two signals cooperate to trigger HVC endothelial cell division and angiogenesis, by inducing the regionally-restricted expression of vascular endothelial growth factor (VEGF), its matrix-releasing protease MMP9, and its Imatinib chemical structure endothelial receptor VEGFR2. The expanded HVC microvascular network then secretes the neurotrophic factor BDNF, which in turn supports the recruitment of newly generated neurons. This process is striking for its spatial restriction and hence functional specificity. While androgen receptors are broadly expressed by the nuclei of the vocal control system, estrogen receptor (ER alpha) expression is largely restricted to HVC and its adjacent mediocaudal neopallium. The geographic overlap of these receptor phenotypes in HVC provides the basis for a regionally-defined set of paracrine interactions between the vascular bed and neuronal progenitor pool that both characterize and distinguish this nucleus.