Objective:Peyronie’s disease(PD)is an abnormal wound healing in the penile tunica albuginea.After fibrotic plaque excision,different graft materials have been used to repair the defects,but the optimal graft remains ...Objective:Peyronie’s disease(PD)is an abnormal wound healing in the penile tunica albuginea.After fibrotic plaque excision,different graft materials have been used to repair the defects,but the optimal graft remains unknown.This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.Methods:A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021.The patients were divided into two groups depending on the type of graft used.For 15 patients in Group B,testicular tunica vaginalis grafts were used to repair the defect,while for 18 patients in Group A,bovine pericardium grafts were used.Data of the patient’s age,comorbidities,sexual function,penile curvature,postoperative complications,need for further treatment,change in penile length,and satisfaction were gathered and compared between the groups.Sexual function was evaluated using the 5-item version of the International Index of Erectile Function(IIEF-5),and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.Results:There was no difference in age,comorbidities,degree of curvature,perioperative IIEF-5,operative time,plaque size,or complication rates.After surgery,a statistically significant improvement in curvature degree(p<0.05)and satisfactory penile appearance(p<0.05)were seen in both groups without any superiority between the two groups(p=0.423 and p=0.840,respectively).With a 30-month follow-up,the IIEF-5 was consistent in both groups,with no statistical significance between the groups(p=0.492).The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance(p=0.255 and p=0.101,respectively).Conclusion:Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.展开更多
Many different materials are available for grafting during surgery for Peyronie＇s disease （PD）. To study the outcomes associated with the use of a lyophilized bovine pericardium graft （Peri-Guard） to repair tunic...Many different materials are available for grafting during surgery for Peyronie＇s disease （PD）. To study the outcomes associated with the use of a lyophilized bovine pericardium graft （Peri-Guard） to repair tunical defects in patients with PD, descriptive study of 43 patients with disabling penile curvature was performed. Curvature was measured before and after the intervention using a standardized procedure. Surgical technique was plaque excision and grafting of the tunical defect carried out by a single surgeon. A lyophilized bovine pericardium patch was used for grafting. We measured the change in penile curvature and length, the ability to perform successful sexual intercourse without further pharmacological or surgical treatment, and the satisfaction with treatment. Follow-up data were available for a total of 41 patients. Median age was 50 years （IQR 48-52）; mean follow-up time was 14 ± 6 months. Complete penile straightening was achieved in 33 patients （80.5%） and five patients （12.2%） had curvature under 20. Three months after surgery and stretching therapy, mean （s.d.） flaccid penile length increased from 11.2 ± 2.8 cm to 12.1 ± 2.9 cm （P = 0.062）. Seventy-five percentage of patients reported being able to achieve successful intercourse without further treatment. Eighty-five percentage of patients reported to be satisfied with the treatment. There was no evidence of tissue rejection or infection, and only four patients suffered an adverse event. Plaque excision and grafting of the tunical defect with lyophilized bovine pericardium seems to be a safe and effective treatment for patients with PD.展开更多
Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. M...Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. Methods: Glutaraldehyde (GA) fixed bovine and camel pericardium samples (BP and CP respectively) were both implanted in 30 New Zealand white rats (2 BP and 2 CP matched specimens in each animal) and explanted after 60 days. Unimplanted GA-fixed samples of both species served as control. Matched implanted samples and unimplanted samples were randomly submitted to elemental analysis by spectroscopy, phospholipid extraction, macroscopic and X-ray examination and histology. Results: At 60 days, calcium and phosphorus content were respectively 9.54% ± 3.1% and 4.79% ± 1.4% of tissue dry weight in BP, and 12.52% ± 2.7% and 6.14% ± 1.3% of tissue dry weight in CP (ns). In X-ray analysis, the calcification score was 1.28 ± 0.45 and 2.14 ± 0.98 in BP and CP samples respectively without significant difference (p < 0.08). In histology, calcifications were lower in BP than in CP: 1.37 ± 0.85 vs 2.28 ± 0.83 (ns);collagen fibers were better conserved in BP than in CP: 2.4 ± 0.48 vs 1.87 ± 0.78 (ns), and less disoriented: 25% vs 62% (ns). In unimplanted samples, there was a higher but not significant rate of extracted lipids in CP: 5.7 ± 1.8 vs 9.5 ± 3.8 nanomoles in PS fraction and 11.3 ± 3.7 vs 19 ± 7.7 nanomoles in total fatty acids, in BP and CP samples respectively. All results were in conjunction and demonstrated a higher but not significant rate of mineralization in camel pericardium after implantation, which could be related to a higher but not significant basic rate of phospholipid and fatty acids. Conclusion: This experiment study in a subcutaneous rat model has failed to valid our hypothesis. Because the differences observed between bovine and camel pericardium did not reach the significance, at the best, there is no difference between both species and at the worst, camel pericardium has a higher rate of the phosphatidylserine fraction of phospholipid, and is more sensitive and prompt to calcification.展开更多
AIM:To employ, in such conditions, a biological graft such as bovine pericardium that offers resistance to infection. METHODS:In our surgical department, from January 2006 to June 2010, 48 patients underwent abdominal...AIM:To employ, in such conditions, a biological graft such as bovine pericardium that offers resistance to infection. METHODS:In our surgical department, from January 2006 to June 2010, 48 patients underwent abdominal wall reconstruction using acellular bovine pericardium; of these 34 patients had a contaminated wound due to diffuse peritonitis (complicated diverticulitis, bowel perforation, intestinal infarction, strangled hernia, etc. ) and 14 patients had hernia relapse on infected synthetic mesh. RESULTS: In our series, one patient died of multiorgan failure 3 d after surgery. After placement of the pericardium mesh four cases of hernia relapse occurred. CONCLUSION: Recurrence rate is similar to that of prosthetic mesh repair and the application of acellular bovine pericardium (Tutomesh , Tutogen Medical Gmbh Germany) is moreover a safe and feasible option thatcan be employed to manage complicated abdominal wall defects where prosthetic mesh is unsuitable.展开更多
BACKGROUND Primitive neuroectodermal tumors(PNETs)are rare,sporadic malignant tumors of the peripheral nervous system,bone,or soft tissues.However,to the best of our knowledge,only three cases of PNET in the pericardi...BACKGROUND Primitive neuroectodermal tumors(PNETs)are rare,sporadic malignant tumors of the peripheral nervous system,bone,or soft tissues.However,to the best of our knowledge,only three cases of PNET in the pericardium have been reported in the English literature,and their magnetic resonance imaging findings have not previously been described.CASE SUMMARY A 3-year-old boy was hospitalized with a 1-wk history of recurrent vomiting and weakness.Detailed history-taking revealed no evidence of heart disease.Computed tomography demonstrated a soft tissue mass in the left pericardial cavity with heterogeneous contrast enhancement.The border between the mass and the heart was poorly defined.Thoracotomy revealed a mass invading the left ventricle,with a high risk of bleeding.The mass was considered inoperable.A biopsy was performed,and the histological and immunohistochemical findings confirmed the diagnosis of primary PNET of the pericardium.The patient received four cycles of standard chemotherapy.Chest magnetic resonance imaging 3 mo after the initiation of chemotherapy revealed that the tumor in the pericardium still existed,but its volume had slightly decreased.The patient was lost to follow-up,and the final outcome was therefore unknown.CONCLUSION Medical imaging plays an important role in defining the pericardial origin of PNET and understanding its characteristics.Magnetic resonance imaging can provide more information on the tumor than computed tomography and may thus aid therapeutic planning.展开更多
Background:Congenital absence of pericardium(CAP),also known as pericardial agenesis,represents an uncommon cardiac abnormality and mostly incidental finding.It can be subdivided into complete and partial(left or righ...Background:Congenital absence of pericardium(CAP),also known as pericardial agenesis,represents an uncommon cardiac abnormality and mostly incidental finding.It can be subdivided into complete and partial(left or right-sided)forms.Because of its infrequency,just case reports and a few case series have been released so far.This paper represents the largest systematic review in the field.Nine features(age at diagnosis,type,gender,clinical presentation,electrocardiography,imaging(ultrasounds,CT/MRI),concomitant cardiac defects,and outcome)were analysed.Methods:The electronic database PubMed was investigated from its establishment up to July 15th,2023.Just case reports and case series were included.Animal studies,papers that were not in English,Spanish,and Italian,and those manuscripts not reporting at least seven of the nine analysed features.were ruled out.The analysed data were reported mostly in terms of percentage.Results:One hundred eighty studies were included encompassing 247 patients.More than half of reviewed CAP cases were in males(63.2%).The mean age at diagnosis was 31.8±19.3 years;a range of 32 weeks of gestation-81 years).23.5%of the patients did not report any symptoms.The most common clinical presentations were chest pain(35.2%)and dyspnoea(29.2%).The most commonly seen ECG changes were right axis deviation(28.7%)and right bundle branch block(23.9%).CAP was suspected or diagnosed by echocardiography in 20.1%of cases.The diagnosis was made by CT and/or MRI in 61.9%of cases.CAP was left-sided in 71.2%,complete in 23.1%,and right-sided in 5.7%.A concomitant congenital heart defect was found in 22.7%,especially in the form of atrial septal defect(6.5%)and patency of ductus arteriosus(2.8%).The pericardial repair was required in 12.9% of the incomplete forms of the disease.Never did the complete form require surgical correction.The outcome appeared favourable in the vast majority of cases,with just 18 deaths(7.3%).Discussion:The main limitation of this systematic review is that it is based just on case reports and case series,due to the lack of large studies on CAP.However,it represents the largest analysis in the field.Due to the rarity of CAP establishing an International Registry is recommended.展开更多
Tricuspid valve endocarditis is a significant cause of valve-related morbidity and mortality. Prosthetic valve reconstruction can be costly and requires life-long anticoagulation. We present our experience with surgic...Tricuspid valve endocarditis is a significant cause of valve-related morbidity and mortality. Prosthetic valve reconstruction can be costly and requires life-long anticoagulation. We present our experience with surgical management of an endocarditis damaged tricuspid valve leaflet in an intravenous drug user. We were able to excise the infected tissue and successfully repair the native valve using autologous pericardium, effectively eliminating the need for prostheses and associated complications. Our case report demonstrates that tricuspid valve reconstruction, using autologous pericar-dium, is a suitable option in patients with tricuspid endocarditis.展开更多
Primary pericardial sarcomas are extremely rare. We report a case of 19 year old male who presented with cough, dyspnoea, and orthopnea. Investigations and exploratory thoracotomy revealed a large pericardial mass. Su...Primary pericardial sarcomas are extremely rare. We report a case of 19 year old male who presented with cough, dyspnoea, and orthopnea. Investigations and exploratory thoracotomy revealed a large pericardial mass. Surgical debulking of the tumor was performed and the histopathological examination was compatible with synovial sarcoma. The tumor was unresectable due to its invasion and adhesion to mediastinal structures. Hence patient was started on palliative chemotherapy (adriamycin and ifosfamide based). Patient showed an initial symptomatic response but later on there was a clinical progres-sion and died within six months of his diagnosis.展开更多
Background:To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic arch.Materials and methods:Fifteen mongrel dogs underwent surgery.The au...Background:To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic arch.Materials and methods:Fifteen mongrel dogs underwent surgery.The autologous pericardial patch was sewn on the aortotomy site in the anterior wall of the aortic arch.The animals were followed up for 3 months postoperatively.Computed tomography angiography was used to visualize and measure the aneurysm model.Hematoxylin and eosin staining was used to observe the histological characteristics of the aneurysm model.Changes in aneurysm diameter over time were analyzed using analysis of variance.Results:One dog died of hemorrhage during surgery.Fourteen dogs survived the surgical procedure.Two of them died on the first postoperative day because of ruptures at the suturing margin.The diameter of the aneurysm model was twice as large as that of the aortic arch.There was no significant change in the maximum diameter of the aneurysm model during the follow-up period.Conclusions:We established a controllable and stable aortic arch aneurysm model created with an autologous pericardium patch.The aneurysm model can be used to research endoleaks after thoracic endovascular aortic repair and new endovascular techniques can be applied to the aortic arch.展开更多
Objective :To observe the effect of electroacupuncture at pericardium meridian on neurological deficit, D-serine ( D-Ser ) content and NMDAR expression in ischemic brain tissue of rats with middle cerebral artery occl...Objective :To observe the effect of electroacupuncture at pericardium meridian on neurological deficit, D-serine ( D-Ser ) content and NMDAR expression in ischemic brain tissue of rats with middle cerebral artery occlusion ( MCAO ). Methods:A total of 36 SD rats were randomly divided into normal group, sham operation group, model group, EA pericardium meridian group, model+D-Ser group,and EA pericardium meridian+D-Ser group. The MCAO model was prepared by Zea Longa method. The model+D-Ser group and the EA pericardium meridian+D-Ser group were given exogenous D-Ser reagent(160 mg/kg i.p.) 30 minutes after the success of the insertion of the suture. EA pericardium meridian group and EA pericardium meridian+D-Ser group were treated with electroacupuncture for 30 min on the next day. The remaining groups were only bound for 30 min.Behavioral evaluation was performed at 6 h after successful modeling and 2 d after intervention, and then the rats were sacrificed. The content of D-Ser in ischemic brain tissue was measured by liquid chromatography tandem mass spectrometry, and the protein expression of NR1, NR2A and NR2B was detected by Western Blot. Results : Before treatment, compared with the normal group and the sham operation group, the behavioral scores of each group increased after modeling (P<0.05 );Compared with the model group, the behavioral scores of the model+D-Ser group and the EA pericardium meridian+D-Ser group were increased (P<0.05).After treatment, compared with the model group, there was no significant difference in the EA pericardium meridian group (P>0.05),The behavioral scores of the model+D-Ser group and the EA pericardium meridian+D-Ser group were still increased (P<0.05);Compared with the model+D-Ser group, the behavioral score of the EA pericardium meridian+D-Ser group was not statistically significant (P>0.05).Comparison before and after treatment in the group,except for the normal group and the sham operation group, the behavioral scores of each group were slightly increased, and the difference was not statistically significant (P>0.05).Compared with the model group, the content of D-Ser and the protein expression of NR1, NR2A and NR2B in the brain tissue of the model+D-Ser group were significantly increased (P<0.05);The protein expression of NR1, NR2A and NR2B decreased in EA pericardium meridian group (P<0.05);Compared with the model+ D-Ser group, the D-Ser content and the protein expression of NR1, NR2A and NR2B in the EA pericardium meridian+D-Ser group were decreased (P<0.05). Conclusion : EA at pericardium meridian points can reduce the D-Ser content in brain tissue of rats with acute MCAO, regulate the decrease of NR1, NR2A and NR2B protein expression, inhibit the NMDA receptor activity, and play a neuroprotective role.展开更多
<strong>Background:</strong><span style="font-family:;" "=""> Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with </span><span style=...<strong>Background:</strong><span style="font-family:;" "=""> Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with </span><span style="font-family:;" "="">the </span><span style="font-family:;" "="">publication of the mid-long term successful resu<span>lts. The aim of this study was to present initial experience of the AVNeo pro</span>cedure of </span><span style="font-family:;" "="">a </span><span style="font-family:;" "="">single center.</span><span style="font-family:;" "=""> </span><b><span style="font-family:;" "="">Methods:</span></b><span style="font-family:;" "=""> The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. <b>Results:</b> The mean age of patients was aged 58.21 ± 13.14 years an<span>d 16 (66.7%) of them were men. 16 patients were operated </span></span><span style="font-family:;" "="">on </span><span style="font-family:;" "="">for aortic steno</span><span style="font-family:;" "="">sis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bi<span>cuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed </span>in 13 (54.17%) patients. No patients needed reoperation for bleeding, pace<span>maker implantations, conversion to classical prosthetic aortic valve replacement</span></span><span style="font-family:;" "="">,</span><span style="font-family:;" "=""> or infective endocarditis. Two patients died due to non-cardiac reasons</span><span style="font-family:;" "="">. Preoperative peak and mean aortic valve pressures improved significantly at 1<sup>st</sup> and 6<sup>th</sup> months (Preop:</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmH<span>g 1<sup>st</sup> month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6<sup>th</sup> month: 18.13 </span>± 3.02 mmHg and 6.93 ± 1.83 mmHg)</span><span style="font-family:;" "="">. </span><b><span style="font-family:;" "="">Conclusion:</span></b><span style="font-family:;" "=""> In conclusion, the AVNe<span>o procedure is a feasible technique for aortic valve pathologies, with the adv</span>antages of avoiding anticoagulants and the applicability of concomitant surgic<span>al procedures. Although this procedure requires meticulous experience, res</span>ults similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.</span>展开更多
Introduction: Simple suture isn’t always possible in large congenital diaphragmatic hernia (cdh) defects. Synthetic materials are used for correction such as Silastic®, Gore-Tex® (GT), Teflon® or...Introduction: Simple suture isn’t always possible in large congenital diaphragmatic hernia (cdh) defects. Synthetic materials are used for correction such as Silastic®, Gore-Tex® (GT), Teflon® or biological, such as autologous muscle patches. It was shown that bovine pericardium (bp) was effective to correct those large defects with many positive outcomes when compared with syntactic materials. Aim: This study aims to establish an experimental model of correction for large diaphragmatic defect with PB and GT patches to compare histologically the tissue interaction between them and diaphragm in young Wistar rats. Materials & Methods: 15 wistar rats were divided in 3 groups: Rats that used BP was named G1;Rats that used GT was named G2;and rats with only scraping in the diphragm, named G3 (control). Animals were submited to a laparotomy and fixed pathces to diaphragms and harvested 3 weeks later. Area between normal diaphragm and patches were isolated and separated for histological analysis, such as lymphocytic infiltration (inflammation), neovascularization and fibrosis. Results: G1 presented inflammation between BP and Diaphragm In 5 Samples. G2 Presented Neovascularization In 5 Samples, But No inflammation. Fibrotic tissue overlapping GT patches occurred in 3 samples in G2. Comparing G1 with G2 there was a significant statistical difference concerning inflammation (P = 0.0079), in G1. Comparing neovascularization there is no significant statistical difference (P = 0.4444), despite a slight higher incidence in G2. Fibrosis in both groups presented no significant statistical difference (P = 0.4444), despite a slight higher incidence in G2. There were no alterations in G3. Discussion: Despite the statistical difference in the inflammatory process was more frequent in G1 (P = 0.0079), neovascularization and fibrosis were more frequent in G2. Conclusion: The proposed experimental model was satisfactory to reproduce suture of patches in the diaphragm. These results suggests that inflammation, neovascularization and fibrosis indeed contribute to a benign healing process that reacts differently in each group but can drive to a more lasting and permanent results when biological patch is considered. Statistical report suggests that this study should be continued with a larger sample of animals and a wider period of time before harvest.展开更多
Hydro-Pericardium Syndrome (HPS) is viral problem of commercial poultry caused by aviadeno virus type-4. In Pakistan the problems have been controlled by administering inactivated infected liver homogenate vaccine (IL...Hydro-Pericardium Syndrome (HPS) is viral problem of commercial poultry caused by aviadeno virus type-4. In Pakistan the problems have been controlled by administering inactivated infected liver homogenate vaccine (ILHV). The use of liver based HPS vaccines remained potential threat for having hypersensitivity reactions in poultry. The current study was carried out to compare the serological potency of HPS ILHV to vero cell line adopted vaccine in term of anti HPS-ELISA antibody titers. 14 HPS virus vaccines were prepared based on different concentration of antigen, type of adjuvants and source of virus substrate. Total of 160 birds were divided into 16 groups each containing 10 birds. At day of 14th age each bird of every group was injected with 0.3 ml dose of respective vaccine. It was observed that HPS infected liver based vaccine having 1 × 105.6, 1 × 105.6 and 1 × 103.6 bird lethal dose 50 induced 1092.10, 875.25 and 702.2 anti-HPS ELISA antibody titer respectively. The 20, 25 and 30 doses/gm HPS infected liver vaccine induced 110.4, 1071.9 and 1037.8 anti-HPS ELISA antibody titer respectively. Montanide based tissue culture HPS vaccine showed significantly higher 1148.45 anti-HPS ELISA antibody titer to aluminium hydroxide based vaccine (137.2) (P 5.6 TCID50 is serological potent against field infection. The vaccines based on such formulation could be prepared in future for effective immuno-prophylaxis against HPS virus.展开更多
Thoracic traumas have an important place among all injuries as they can cause significant mortality and morbidity. The thoracic injuries are the large part of trauma with head and extremity injuries. Thoracic traumas ...Thoracic traumas have an important place among all injuries as they can cause significant mortality and morbidity. The thoracic injuries are the large part of trauma with head and extremity injuries. Thoracic traumas are divided into two groups, including penetrating and blunt. The primary causes for penetrating traumas are wounds caused by gunshot and sharp objects. The lungs are the most injured organ in penetrating thoracic traumas with many organ injuries accompanied. This case report is about a rebar impalement into bilateral hemitoraces and pericardium after falling down in spite of any injury is not occurred in heart, lung and great vessels. The fact that an injury to such an extent does not cause any intrathoracic catastrophic event is something that has not been reported in the past.展开更多
Objective： To search for the best procedure on preparation ofacellular bovine pericardium,so to provide scaffolds for constructing tissue-engineering Methods： The bovine pericardiums were treated with 5 methods, whi...Objective： To search for the best procedure on preparation ofacellular bovine pericardium,so to provide scaffolds for constructing tissue-engineering Methods： The bovine pericardiums were treated with 5 methods, which were divided into 6 groupsGroup A： Fresh bovinepericardium; Group B： Trypsin-detergent group;Group C： Freeze-thaw-detergent 24 h group; Group I）： Freeze-thaw-detergent 48 h group; Group Fz Freeze-thaw-nuclease group; Group F： Detergent-nuclease group. Then, by HE staining and scanning electron microscope to observe the effects ofdecellularization and fibrous changes among the 6 groups; by water content testingonechanical testing to observe the changes in physical properties of the matrix; by detecting the DNA content of each group to determine the effect of deeellularization qualitatively; by eytotoxieity test to detect the biocompatibility of bovine pericardium in each group. Results： The 5 methods can all remove the cellular components effectively, compared with the fresh bovine pericardium,the water content of each deeellularized group were increased （P〈0.05）, while the DNA content decreased （P〈0.05）, with statistically significant differences. Of group E, the fibers were a little disorder, with the largest tension and the elastic modulus increased, while the rupture tensile rate decreased. Compared with fresh bovine pericardium,the largest tension of the other decellularization groups were all decreased （P〈0.05）. The fibers of group B, group D were irregularly arranged and also with ruptures, both the elastic modulus and the rupture tensile rate decreased（P〈0.05）. In group C and F, the fibers were dense and their direction was normal, the elastic modulus and the rupture tensile rate were similar to the fresh bovine pericardium （P〉0.05）. Cytotoxicity results showed that the cell toxicity of group B, group C, group D, group E and group F were respectively 0.9, 0.6, 1.0, 1.0 and 0.5, each group were qualified toxicity test, in which group C and group F were with the lowest eytotoxieity. Conclusion： Group C and group F can remove the cell components of bovine pericardium successfully,while maintaining the major structural components and the histological and biological properties of bovine pericardium,and with low cytotoxicity.However, group C is more economical than group F,and easier to operate. So the method on freeze-thaw-detergent 24 h can be the best choice to produce a decellularized bovine pericardium.展开更多
The study used a naturally occurring crosslinking reagent-genipin to chemically modify acellular bovine pericardium, prepare cardiac valve tissue engineering scaffold material,and evaluated genipin crosslinked acellul...The study used a naturally occurring crosslinking reagent-genipin to chemically modify acellular bovine pericardium, prepare cardiac valve tissue engineering scaffold material,and evaluated genipin crosslinked acellular matrix of bovine pericardium by investigating the physical and chemical properties of the tissues, such as the surface properties, crosslinking characteristics, mechanical properties, resistance to enzymatic capacity in vitro, and hemolysis tests. The results showed that acellular bovine pericardium matrix erosslinked with genipin was strong hydrophilicity, high crosslinking index, and stable structure, which can maintain good mechanical properties. As a kind of scaffold material for valve tissue engineering, it has wide application prospect.展开更多
Objective To review the clinical experience of reconstruction of pulmonary artery(PA) by a patch of autologus pericardium or azygous venae for non-small cell lung cancer. Methods Between March 1992 and August 2009,62 ...Objective To review the clinical experience of reconstruction of pulmonary artery(PA) by a patch of autologus pericardium or azygous venae for non-small cell lung cancer. Methods Between March 1992 and August 2009,62 patients with locally advanced central lung cancer received sleeve resection and reconstruction of PA.展开更多
文摘Objective:Peyronie’s disease(PD)is an abnormal wound healing in the penile tunica albuginea.After fibrotic plaque excision,different graft materials have been used to repair the defects,but the optimal graft remains unknown.This study aimed to compare the functional outcomes of testicular tunica vaginalis grafts and bovine pericardium grafts in patients with severe PD.Methods:A retrospective comparative study was conducted on 33 PD patients undergoing partial plaque excision and grafting from September 2015 to May 2021.The patients were divided into two groups depending on the type of graft used.For 15 patients in Group B,testicular tunica vaginalis grafts were used to repair the defect,while for 18 patients in Group A,bovine pericardium grafts were used.Data of the patient’s age,comorbidities,sexual function,penile curvature,postoperative complications,need for further treatment,change in penile length,and satisfaction were gathered and compared between the groups.Sexual function was evaluated using the 5-item version of the International Index of Erectile Function(IIEF-5),and a functional less than 20-degree penile curvature after surgery was considered a successful intervention.Results:There was no difference in age,comorbidities,degree of curvature,perioperative IIEF-5,operative time,plaque size,or complication rates.After surgery,a statistically significant improvement in curvature degree(p<0.05)and satisfactory penile appearance(p<0.05)were seen in both groups without any superiority between the two groups(p=0.423 and p=0.840,respectively).With a 30-month follow-up,the IIEF-5 was consistent in both groups,with no statistical significance between the groups(p=0.492).The main change in penile length during the operation was increased and still positive in the last follow-up in both groups without statistical significance(p=0.255 and p=0.101,respectively).Conclusion:Partial plaque excision and corporoplasty with both testicular tunica vaginalis or bovine pericardium grafts are equally effective in treating males with clinically significant PD.
文摘Many different materials are available for grafting during surgery for Peyronie＇s disease （PD）. To study the outcomes associated with the use of a lyophilized bovine pericardium graft （Peri-Guard） to repair tunical defects in patients with PD, descriptive study of 43 patients with disabling penile curvature was performed. Curvature was measured before and after the intervention using a standardized procedure. Surgical technique was plaque excision and grafting of the tunical defect carried out by a single surgeon. A lyophilized bovine pericardium patch was used for grafting. We measured the change in penile curvature and length, the ability to perform successful sexual intercourse without further pharmacological or surgical treatment, and the satisfaction with treatment. Follow-up data were available for a total of 41 patients. Median age was 50 years （IQR 48-52）; mean follow-up time was 14 ± 6 months. Complete penile straightening was achieved in 33 patients （80.5%） and five patients （12.2%） had curvature under 20. Three months after surgery and stretching therapy, mean （s.d.） flaccid penile length increased from 11.2 ± 2.8 cm to 12.1 ± 2.9 cm （P = 0.062）. Seventy-five percentage of patients reported being able to achieve successful intercourse without further treatment. Eighty-five percentage of patients reported to be satisfied with the treatment. There was no evidence of tissue rejection or infection, and only four patients suffered an adverse event. Plaque excision and grafting of the tunical defect with lyophilized bovine pericardium seems to be a safe and effective treatment for patients with PD.
文摘Objective: To validate the hypothesis that camel pericardium could be more protected than bovine pericardium against calcification process according to the huge difference in their respective lifestyle and lifetime. Methods: Glutaraldehyde (GA) fixed bovine and camel pericardium samples (BP and CP respectively) were both implanted in 30 New Zealand white rats (2 BP and 2 CP matched specimens in each animal) and explanted after 60 days. Unimplanted GA-fixed samples of both species served as control. Matched implanted samples and unimplanted samples were randomly submitted to elemental analysis by spectroscopy, phospholipid extraction, macroscopic and X-ray examination and histology. Results: At 60 days, calcium and phosphorus content were respectively 9.54% ± 3.1% and 4.79% ± 1.4% of tissue dry weight in BP, and 12.52% ± 2.7% and 6.14% ± 1.3% of tissue dry weight in CP (ns). In X-ray analysis, the calcification score was 1.28 ± 0.45 and 2.14 ± 0.98 in BP and CP samples respectively without significant difference (p < 0.08). In histology, calcifications were lower in BP than in CP: 1.37 ± 0.85 vs 2.28 ± 0.83 (ns);collagen fibers were better conserved in BP than in CP: 2.4 ± 0.48 vs 1.87 ± 0.78 (ns), and less disoriented: 25% vs 62% (ns). In unimplanted samples, there was a higher but not significant rate of extracted lipids in CP: 5.7 ± 1.8 vs 9.5 ± 3.8 nanomoles in PS fraction and 11.3 ± 3.7 vs 19 ± 7.7 nanomoles in total fatty acids, in BP and CP samples respectively. All results were in conjunction and demonstrated a higher but not significant rate of mineralization in camel pericardium after implantation, which could be related to a higher but not significant basic rate of phospholipid and fatty acids. Conclusion: This experiment study in a subcutaneous rat model has failed to valid our hypothesis. Because the differences observed between bovine and camel pericardium did not reach the significance, at the best, there is no difference between both species and at the worst, camel pericardium has a higher rate of the phosphatidylserine fraction of phospholipid, and is more sensitive and prompt to calcification.
文摘AIM:To employ, in such conditions, a biological graft such as bovine pericardium that offers resistance to infection. METHODS:In our surgical department, from January 2006 to June 2010, 48 patients underwent abdominal wall reconstruction using acellular bovine pericardium; of these 34 patients had a contaminated wound due to diffuse peritonitis (complicated diverticulitis, bowel perforation, intestinal infarction, strangled hernia, etc. ) and 14 patients had hernia relapse on infected synthetic mesh. RESULTS: In our series, one patient died of multiorgan failure 3 d after surgery. After placement of the pericardium mesh four cases of hernia relapse occurred. CONCLUSION: Recurrence rate is similar to that of prosthetic mesh repair and the application of acellular bovine pericardium (Tutomesh , Tutogen Medical Gmbh Germany) is moreover a safe and feasible option thatcan be employed to manage complicated abdominal wall defects where prosthetic mesh is unsuitable.
基金Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province,No.(2016)97.
文摘BACKGROUND Primitive neuroectodermal tumors(PNETs)are rare,sporadic malignant tumors of the peripheral nervous system,bone,or soft tissues.However,to the best of our knowledge,only three cases of PNET in the pericardium have been reported in the English literature,and their magnetic resonance imaging findings have not previously been described.CASE SUMMARY A 3-year-old boy was hospitalized with a 1-wk history of recurrent vomiting and weakness.Detailed history-taking revealed no evidence of heart disease.Computed tomography demonstrated a soft tissue mass in the left pericardial cavity with heterogeneous contrast enhancement.The border between the mass and the heart was poorly defined.Thoracotomy revealed a mass invading the left ventricle,with a high risk of bleeding.The mass was considered inoperable.A biopsy was performed,and the histological and immunohistochemical findings confirmed the diagnosis of primary PNET of the pericardium.The patient received four cycles of standard chemotherapy.Chest magnetic resonance imaging 3 mo after the initiation of chemotherapy revealed that the tumor in the pericardium still existed,but its volume had slightly decreased.The patient was lost to follow-up,and the final outcome was therefore unknown.CONCLUSION Medical imaging plays an important role in defining the pericardial origin of PNET and understanding its characteristics.Magnetic resonance imaging can provide more information on the tumor than computed tomography and may thus aid therapeutic planning.
文摘Background:Congenital absence of pericardium(CAP),also known as pericardial agenesis,represents an uncommon cardiac abnormality and mostly incidental finding.It can be subdivided into complete and partial(left or right-sided)forms.Because of its infrequency,just case reports and a few case series have been released so far.This paper represents the largest systematic review in the field.Nine features(age at diagnosis,type,gender,clinical presentation,electrocardiography,imaging(ultrasounds,CT/MRI),concomitant cardiac defects,and outcome)were analysed.Methods:The electronic database PubMed was investigated from its establishment up to July 15th,2023.Just case reports and case series were included.Animal studies,papers that were not in English,Spanish,and Italian,and those manuscripts not reporting at least seven of the nine analysed features.were ruled out.The analysed data were reported mostly in terms of percentage.Results:One hundred eighty studies were included encompassing 247 patients.More than half of reviewed CAP cases were in males(63.2%).The mean age at diagnosis was 31.8±19.3 years;a range of 32 weeks of gestation-81 years).23.5%of the patients did not report any symptoms.The most common clinical presentations were chest pain(35.2%)and dyspnoea(29.2%).The most commonly seen ECG changes were right axis deviation(28.7%)and right bundle branch block(23.9%).CAP was suspected or diagnosed by echocardiography in 20.1%of cases.The diagnosis was made by CT and/or MRI in 61.9%of cases.CAP was left-sided in 71.2%,complete in 23.1%,and right-sided in 5.7%.A concomitant congenital heart defect was found in 22.7%,especially in the form of atrial septal defect(6.5%)and patency of ductus arteriosus(2.8%).The pericardial repair was required in 12.9% of the incomplete forms of the disease.Never did the complete form require surgical correction.The outcome appeared favourable in the vast majority of cases,with just 18 deaths(7.3%).Discussion:The main limitation of this systematic review is that it is based just on case reports and case series,due to the lack of large studies on CAP.However,it represents the largest analysis in the field.Due to the rarity of CAP establishing an International Registry is recommended.
文摘Tricuspid valve endocarditis is a significant cause of valve-related morbidity and mortality. Prosthetic valve reconstruction can be costly and requires life-long anticoagulation. We present our experience with surgical management of an endocarditis damaged tricuspid valve leaflet in an intravenous drug user. We were able to excise the infected tissue and successfully repair the native valve using autologous pericardium, effectively eliminating the need for prostheses and associated complications. Our case report demonstrates that tricuspid valve reconstruction, using autologous pericar-dium, is a suitable option in patients with tricuspid endocarditis.
文摘Primary pericardial sarcomas are extremely rare. We report a case of 19 year old male who presented with cough, dyspnoea, and orthopnea. Investigations and exploratory thoracotomy revealed a large pericardial mass. Surgical debulking of the tumor was performed and the histopathological examination was compatible with synovial sarcoma. The tumor was unresectable due to its invasion and adhesion to mediastinal structures. Hence patient was started on palliative chemotherapy (adriamycin and ifosfamide based). Patient showed an initial symptomatic response but later on there was a clinical progres-sion and died within six months of his diagnosis.
基金supported by the Henan medical science and technology research projects(222102310014 and LGHJ20200058)。
文摘Background:To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic arch.Materials and methods:Fifteen mongrel dogs underwent surgery.The autologous pericardial patch was sewn on the aortotomy site in the anterior wall of the aortic arch.The animals were followed up for 3 months postoperatively.Computed tomography angiography was used to visualize and measure the aneurysm model.Hematoxylin and eosin staining was used to observe the histological characteristics of the aneurysm model.Changes in aneurysm diameter over time were analyzed using analysis of variance.Results:One dog died of hemorrhage during surgery.Fourteen dogs survived the surgical procedure.Two of them died on the first postoperative day because of ruptures at the suturing margin.The diameter of the aneurysm model was twice as large as that of the aortic arch.There was no significant change in the maximum diameter of the aneurysm model during the follow-up period.Conclusions:We established a controllable and stable aortic arch aneurysm model created with an autologous pericardium patch.The aneurysm model can be used to research endoleaks after thoracic endovascular aortic repair and new endovascular techniques can be applied to the aortic arch.
基金National Natural Science Foundation of China (No.81774421)Natural Science Foundation of Hunan Province (No.2018JJ2306)Hunan Provincial General Project of Postgraduate Scientific Research Innovation (No.CX20200809)。
文摘Objective :To observe the effect of electroacupuncture at pericardium meridian on neurological deficit, D-serine ( D-Ser ) content and NMDAR expression in ischemic brain tissue of rats with middle cerebral artery occlusion ( MCAO ). Methods:A total of 36 SD rats were randomly divided into normal group, sham operation group, model group, EA pericardium meridian group, model+D-Ser group,and EA pericardium meridian+D-Ser group. The MCAO model was prepared by Zea Longa method. The model+D-Ser group and the EA pericardium meridian+D-Ser group were given exogenous D-Ser reagent(160 mg/kg i.p.) 30 minutes after the success of the insertion of the suture. EA pericardium meridian group and EA pericardium meridian+D-Ser group were treated with electroacupuncture for 30 min on the next day. The remaining groups were only bound for 30 min.Behavioral evaluation was performed at 6 h after successful modeling and 2 d after intervention, and then the rats were sacrificed. The content of D-Ser in ischemic brain tissue was measured by liquid chromatography tandem mass spectrometry, and the protein expression of NR1, NR2A and NR2B was detected by Western Blot. Results : Before treatment, compared with the normal group and the sham operation group, the behavioral scores of each group increased after modeling (P<0.05 );Compared with the model group, the behavioral scores of the model+D-Ser group and the EA pericardium meridian+D-Ser group were increased (P<0.05).After treatment, compared with the model group, there was no significant difference in the EA pericardium meridian group (P>0.05),The behavioral scores of the model+D-Ser group and the EA pericardium meridian+D-Ser group were still increased (P<0.05);Compared with the model+D-Ser group, the behavioral score of the EA pericardium meridian+D-Ser group was not statistically significant (P>0.05).Comparison before and after treatment in the group,except for the normal group and the sham operation group, the behavioral scores of each group were slightly increased, and the difference was not statistically significant (P>0.05).Compared with the model group, the content of D-Ser and the protein expression of NR1, NR2A and NR2B in the brain tissue of the model+D-Ser group were significantly increased (P<0.05);The protein expression of NR1, NR2A and NR2B decreased in EA pericardium meridian group (P<0.05);Compared with the model+ D-Ser group, the D-Ser content and the protein expression of NR1, NR2A and NR2B in the EA pericardium meridian+D-Ser group were decreased (P<0.05). Conclusion : EA at pericardium meridian points can reduce the D-Ser content in brain tissue of rats with acute MCAO, regulate the decrease of NR1, NR2A and NR2B protein expression, inhibit the NMDA receptor activity, and play a neuroprotective role.
文摘<strong>Background:</strong><span style="font-family:;" "=""> Aortic neo-cuspidization (AVNeo) procedure has been adopted by limited centers with </span><span style="font-family:;" "="">the </span><span style="font-family:;" "="">publication of the mid-long term successful resu<span>lts. The aim of this study was to present initial experience of the AVNeo pro</span>cedure of </span><span style="font-family:;" "="">a </span><span style="font-family:;" "="">single center.</span><span style="font-family:;" "=""> </span><b><span style="font-family:;" "="">Methods:</span></b><span style="font-family:;" "=""> The medical records of 24 patients who underwent AVNeo with or without concomitant cardiac surgery between February 2019 and February 2021 at our tertiary hospital were scanned retrospectively. <b>Results:</b> The mean age of patients was aged 58.21 ± 13.14 years an<span>d 16 (66.7%) of them were men. 16 patients were operated </span></span><span style="font-family:;" "="">on </span><span style="font-family:;" "="">for aortic steno</span><span style="font-family:;" "="">sis (66.67%). Morphology of the aortic valve was tricuspid in 21 (87.5%) and bi<span>cuspid in 3 (12.5%) of the patients. Additional cardicac surgery was performed </span>in 13 (54.17%) patients. No patients needed reoperation for bleeding, pace<span>maker implantations, conversion to classical prosthetic aortic valve replacement</span></span><span style="font-family:;" "="">,</span><span style="font-family:;" "=""> or infective endocarditis. Two patients died due to non-cardiac reasons</span><span style="font-family:;" "="">. Preoperative peak and mean aortic valve pressures improved significantly at 1<sup>st</sup> and 6<sup>th</sup> months (Preop:</span><span style="font-family:;" "=""> </span><span style="font-family:;" "="">89.06 ± 21.88 mmHg and 56.38 ± 15.09 mmH<span>g 1<sup>st</sup> month: 22.00 ± 3.93 mmHg and 8.73 ± 2.60 mmHg, 6<sup>th</sup> month: 18.13 </span>± 3.02 mmHg and 6.93 ± 1.83 mmHg)</span><span style="font-family:;" "="">. </span><b><span style="font-family:;" "="">Conclusion:</span></b><span style="font-family:;" "=""> In conclusion, the AVNe<span>o procedure is a feasible technique for aortic valve pathologies, with the adv</span>antages of avoiding anticoagulants and the applicability of concomitant surgic<span>al procedures. Although this procedure requires meticulous experience, res</span>ults similar to the available published literature can be obtained and reproducible even during learning curve when technical steps are strictly followed.</span>
文摘Introduction: Simple suture isn’t always possible in large congenital diaphragmatic hernia (cdh) defects. Synthetic materials are used for correction such as Silastic®, Gore-Tex® (GT), Teflon® or biological, such as autologous muscle patches. It was shown that bovine pericardium (bp) was effective to correct those large defects with many positive outcomes when compared with syntactic materials. Aim: This study aims to establish an experimental model of correction for large diaphragmatic defect with PB and GT patches to compare histologically the tissue interaction between them and diaphragm in young Wistar rats. Materials & Methods: 15 wistar rats were divided in 3 groups: Rats that used BP was named G1;Rats that used GT was named G2;and rats with only scraping in the diphragm, named G3 (control). Animals were submited to a laparotomy and fixed pathces to diaphragms and harvested 3 weeks later. Area between normal diaphragm and patches were isolated and separated for histological analysis, such as lymphocytic infiltration (inflammation), neovascularization and fibrosis. Results: G1 presented inflammation between BP and Diaphragm In 5 Samples. G2 Presented Neovascularization In 5 Samples, But No inflammation. Fibrotic tissue overlapping GT patches occurred in 3 samples in G2. Comparing G1 with G2 there was a significant statistical difference concerning inflammation (P = 0.0079), in G1. Comparing neovascularization there is no significant statistical difference (P = 0.4444), despite a slight higher incidence in G2. Fibrosis in both groups presented no significant statistical difference (P = 0.4444), despite a slight higher incidence in G2. There were no alterations in G3. Discussion: Despite the statistical difference in the inflammatory process was more frequent in G1 (P = 0.0079), neovascularization and fibrosis were more frequent in G2. Conclusion: The proposed experimental model was satisfactory to reproduce suture of patches in the diaphragm. These results suggests that inflammation, neovascularization and fibrosis indeed contribute to a benign healing process that reacts differently in each group but can drive to a more lasting and permanent results when biological patch is considered. Statistical report suggests that this study should be continued with a larger sample of animals and a wider period of time before harvest.
文摘Hydro-Pericardium Syndrome (HPS) is viral problem of commercial poultry caused by aviadeno virus type-4. In Pakistan the problems have been controlled by administering inactivated infected liver homogenate vaccine (ILHV). The use of liver based HPS vaccines remained potential threat for having hypersensitivity reactions in poultry. The current study was carried out to compare the serological potency of HPS ILHV to vero cell line adopted vaccine in term of anti HPS-ELISA antibody titers. 14 HPS virus vaccines were prepared based on different concentration of antigen, type of adjuvants and source of virus substrate. Total of 160 birds were divided into 16 groups each containing 10 birds. At day of 14th age each bird of every group was injected with 0.3 ml dose of respective vaccine. It was observed that HPS infected liver based vaccine having 1 × 105.6, 1 × 105.6 and 1 × 103.6 bird lethal dose 50 induced 1092.10, 875.25 and 702.2 anti-HPS ELISA antibody titer respectively. The 20, 25 and 30 doses/gm HPS infected liver vaccine induced 110.4, 1071.9 and 1037.8 anti-HPS ELISA antibody titer respectively. Montanide based tissue culture HPS vaccine showed significantly higher 1148.45 anti-HPS ELISA antibody titer to aluminium hydroxide based vaccine (137.2) (P 5.6 TCID50 is serological potent against field infection. The vaccines based on such formulation could be prepared in future for effective immuno-prophylaxis against HPS virus.
文摘Thoracic traumas have an important place among all injuries as they can cause significant mortality and morbidity. The thoracic injuries are the large part of trauma with head and extremity injuries. Thoracic traumas are divided into two groups, including penetrating and blunt. The primary causes for penetrating traumas are wounds caused by gunshot and sharp objects. The lungs are the most injured organ in penetrating thoracic traumas with many organ injuries accompanied. This case report is about a rebar impalement into bilateral hemitoraces and pericardium after falling down in spite of any injury is not occurred in heart, lung and great vessels. The fact that an injury to such an extent does not cause any intrathoracic catastrophic event is something that has not been reported in the past.
文摘Objective： To search for the best procedure on preparation ofacellular bovine pericardium,so to provide scaffolds for constructing tissue-engineering Methods： The bovine pericardiums were treated with 5 methods, which were divided into 6 groupsGroup A： Fresh bovinepericardium; Group B： Trypsin-detergent group;Group C： Freeze-thaw-detergent 24 h group; Group I）： Freeze-thaw-detergent 48 h group; Group Fz Freeze-thaw-nuclease group; Group F： Detergent-nuclease group. Then, by HE staining and scanning electron microscope to observe the effects ofdecellularization and fibrous changes among the 6 groups; by water content testingonechanical testing to observe the changes in physical properties of the matrix; by detecting the DNA content of each group to determine the effect of deeellularization qualitatively; by eytotoxieity test to detect the biocompatibility of bovine pericardium in each group. Results： The 5 methods can all remove the cellular components effectively, compared with the fresh bovine pericardium,the water content of each deeellularized group were increased （P〈0.05）, while the DNA content decreased （P〈0.05）, with statistically significant differences. Of group E, the fibers were a little disorder, with the largest tension and the elastic modulus increased, while the rupture tensile rate decreased. Compared with fresh bovine pericardium,the largest tension of the other decellularization groups were all decreased （P〈0.05）. The fibers of group B, group D were irregularly arranged and also with ruptures, both the elastic modulus and the rupture tensile rate decreased（P〈0.05）. In group C and F, the fibers were dense and their direction was normal, the elastic modulus and the rupture tensile rate were similar to the fresh bovine pericardium （P〉0.05）. Cytotoxicity results showed that the cell toxicity of group B, group C, group D, group E and group F were respectively 0.9, 0.6, 1.0, 1.0 and 0.5, each group were qualified toxicity test, in which group C and group F were with the lowest eytotoxieity. Conclusion： Group C and group F can remove the cell components of bovine pericardium successfully,while maintaining the major structural components and the histological and biological properties of bovine pericardium,and with low cytotoxicity.However, group C is more economical than group F,and easier to operate. So the method on freeze-thaw-detergent 24 h can be the best choice to produce a decellularized bovine pericardium.
基金National High-tech Research and Development Program(836 Prgoram) of Chinagrant number:2007AA02Z444+1 种基金National BasicProgram of China (973 Program)grant number:2009CB930000
文摘The study used a naturally occurring crosslinking reagent-genipin to chemically modify acellular bovine pericardium, prepare cardiac valve tissue engineering scaffold material,and evaluated genipin crosslinked acellular matrix of bovine pericardium by investigating the physical and chemical properties of the tissues, such as the surface properties, crosslinking characteristics, mechanical properties, resistance to enzymatic capacity in vitro, and hemolysis tests. The results showed that acellular bovine pericardium matrix erosslinked with genipin was strong hydrophilicity, high crosslinking index, and stable structure, which can maintain good mechanical properties. As a kind of scaffold material for valve tissue engineering, it has wide application prospect.
文摘Objective To review the clinical experience of reconstruction of pulmonary artery(PA) by a patch of autologus pericardium or azygous venae for non-small cell lung cancer. Methods Between March 1992 and August 2009,62 patients with locally advanced central lung cancer received sleeve resection and reconstruction of PA.
