Thoracic Surgery Research Research Articles

Thoracic surgery and lung transplantation

When two pre-existing European respiratory societies (the Societas Europaea Physiologiae Clinicae Respoiratoriae (SEPCR) and the European Society of Pneumology (SEP)) merged 20 years ago to form the European Respiratory Society (ERS) 1, the Thoracic Surgery Assembly was established within the new Society. The foundation of our Assembly was the result of founder pneumologists’ and thoracic surgeons’ conviction of the need for collaboration between these two medical specialties. Such collaboration occurs in everyday work and, indeed, our community is enriched when our efforts are combined to form a wider spectrum of scientific knowledge 2. In preparation for this Editorial, we conducted an informal survey of colleagues from different countries and from teaching, research and clinical backgrounds in thoracic surgery, and asked them how the specialty is considered, taught and organised in their country. We asked about training in thoracic surgery (whether there is a specific training programme, whether training is provided after general surgery or combined with cardiac surgery, and how trainees can enter residency programmes), working in the specialty at a professional level (time taken to gain a position after the residency period, excess or lack of specialists, and possible conflict with other surgical specialties), and finally about national and European scientific societies (whether they are only for general thoracic surgeons or shared with other specialties like pneumology, general surgery or cardiac surgery). As a result of our colleagues’ responses, we can separate thoracic surgery in Europe into three different categories: Northern Europe (including Scandinavia, Germany, the UK and France); Eastern Europe (Russia and the Newly Independent States); Southern Europe (including Spain, Italy, Serbia and Greece). Each category has distinct features in terms of training, performance and collaboration in thoracic surgery, as follows. Northern Europe: In Northern Europe, training in thoracic surgery is combined with cardiac surgery (with …

Modelo experimental de perfusão pulmonar isolada em ratos: técnica e aplicações em estudos de preservação pulmonar

Small animal models are particularly suitable for lung preservation studies, because they are simple and cost-effective. This brief communication focuses on the technical description of an ex vivo lung perfusion model in rats by means of a commercially available apparatus, which was the first to be installed in a thoracic surgery research laboratory in Brazil. The model and its preparation, together with its applications for lung preservation studies, are described in detail. All technical details can also be seen in a video posted on the website of the Brazilian Journal of Pulmonology.

Fifty years of thoracic surgical research in South Africa.

To investigate the scope and trends in clinical research in South African thoracic surgery between 1955 and 2006 and to measure its impact on clinical practice. A systematic review of all SA thoracic surgical publications was performed. There were 252 general thoracic publications and a marked decrease in publications was noted after the peak period of productivity of the 1980s. There was a shift toward the private sector as an origin of articles and toward a local, non-indexed journal. Inflammatory lung disease was the most frequent topic of publication. Case series and case reports were the most frequent type of article. The vulnerability of a small specialty in a developing country is illustrated by the clear trends that emerged. The study provides important indicators for future research, highlights the need for a national database of clinical experience, and emphasises the importance of rekindling interest and a culture of research in thoracic surgery.

Women in thoracic surgery and the Thoracic Surgery Foundation for Research and Education

Women in thoracic surgery have been important in the founding and subsequent development of The Thoracic Surgery Foundation for Research and Education. In 1984, Dr Martin McKneally first proposed the creation of a foundation to support research and education in thoracic surgery. In 1989, the Society of Thoracic Surgeon Education and Research Foundation was established. Because of limited financial support, its programs were minimal. In 1992, Dr Eugene Braunwald, desiring to establish a memorial to his wife, Dr Nina Starr Braunwald, was directed to the Foundation. Dr Braunwald, family, friends, and colleagues of the late Nina Starr Braunwald provided the Foundation with a major gift to establish the Nina Starr Braunwald Memorial Fund. This provided the impetus for support from the four major thoracic surgery organizations: The American Association for Thoracic Surgery (AATS), The Society of Thoracic Surgeons (STS), The Southern Thoracic Surgery Association (STSA), and The Western Thoracic Surgery Association (WTSA), and The Society of Thoracic Surgeons for Education and Research was reorganized as The Thoracic Surgery Foundation for Research and Education to serve all of thoracic surgery. Nina Starr Braunwald was not only an outstanding pioneer woman thoracic surgeon, but an outstanding surgeon among all surgeons. Dr Braunwald was born in New York in 1928. She had her undergraduate and medical education at New York University and embarked on her surgical training at Bellevue Hospital. She completed her general surgery training at Georgetown University Medical Center where she also obtained a Master of Science Degree in Surgery, working as a postdoctoral fellow in the laboratory of Dr Charles Hufnagel. Her cardiothoracic surgery training was accomplished at the National Heart Institute under Dr Andrew Morrow. In 1961, she became the first woman to be certified by the American Board of Thoracic Surgery. Doctor Braunwald’s career included appointments as Deputy Chief, The Clinic of Surgery at the National Heart Institute, Associate Professor of Surgery at the University of California at San Diego, where she established that institution’s first cardiac surgical program. In 1972, she accepted an appointment as Associate Professor in Surgery at Harvard with staff appointments at the Brigham and Women’s, Boston Children’s, and the West Roxbury Veteran’s Administration Hospital. Throughout Dr Braunwald’s career, she was recognized as a true academic surgeon with achievements and contributions in research, clinical surgery, and education. Many of the current leaders of thoracic surgery owe much of their career success to their association with Nina Braunwald. Doctor Braunwald’s bibliography of over 150 publications delineates her interests and contributions to cardiac surgery. These include measurement of extracellular fluid compartments, basic studies in tissue transplantation, and, most importantly, her pioneering work in the design and fabrication of mechanical heart valves. This work led to her performing the first successful mitral valve replacement with a prosthetic valve. Doctor Braunwald was recognized and honored by many organizations. She received the Distinguished Member Award of The Association of Women’s Surgeons and was the first woman elected to membership in The American Association for Thoracic Surgery. The Nina Starr Braunwald Memorial Fund provides research fellowships and career development awards for women in thoracic surgery. This fund of The Thoracic Surgery Foundation has grown to over $2,000,000 and is now sufficient to ensure these awards in perpetuity, a most appropriate memorial to an outstanding thoracic surgeon. Since 1993, the Foundation has made research awards to eight women: four Nina Braunwald Research Fellowships, three Nina Braunwald Career Development Awards, and one Thoracic Surgery Foundation Fellowship.

The Asia pacific heart journal readers' preferences survey, 1999

Background: With a shift in geographical focus to include the Pacific rim, and with the Journal's scope now broadened to embrace cardiology, the Editorial Board of the APHJ wished to obtain the views of the wider readership on the Journal format and style. Aim: To determine the views of readers in the evolving process of structuring the Journal and to stimulate discussion about the future role of the APHJ. Method. Subscribers were asked anonymously by questionnaire for their views on the subjects and styles of articles currently published by the Journal. Results: One-hundred and two replies were received (a response rate of 15%). The main subjects of interest were, in order of importance: cardiology, cardiac surgery, thoracic surgery and basic research, these being a reflection of the professional interests of the responders. Cardiologists were interested primarily in articles on general clinical cardiology, followed by interventional cardiology and clinical research. Cardiothoracic surgeons showed an overwhelming primary interest in cardiac surgery, followed by thoracic surgery and clinical research, a reflection of the higher response rate from cardiac compared with thoracic surgeons. Interests in basic research were in physiology, followed by atherosclerosis, pharmacology and molecular biology. Conclusion: The most popular styles of articles for all disciplines were reviews by experts, followed by original research papers and scientific editorials. These, in turn, were more highly favoured than professional editorials, how-to-do-it articles and case reports. The Editorial Board has taken heed of these views and is now using this information in setting the Journal style for the future.

Staging of lung cancer: The new international system

Abstract New recommendations for staging lung cancer using the TNM system for description of the primary tumor (T), the regional lymph nodes (N), and distant metastases (M) have been adopted by the American Joint Committee on Cancer and the Union Internationale Contre le Cancer. Revisions in TNM definitions and stage grouping rules were made in response to the needs of investigators throughout the world for staging that is consistent in meaning among all specialities and among all countries. The new international system has five stage groups, O, I, II, IIIa, IIIb and IV, that provide for classification of six levels of disease extent. A number of elements used in prior staging recommendations have been retained; however, new descriptors for the degree of progression in tumors with extrapulmonary extension and for the levels of regional lymph node metastasis have been structured. The new system allows for specific definition of ‘limited’ and ‘extensive’ disease categories that can be reproduced and compared. It meets the goal of providing an internationally acceptable staging system for lung cancer that is useful for estimating prognosis, reporting end results and selection of appropriate treatment. A new system for staging lung cancer has been accepted by international groups concerned with uniform classification of the extent of disease in cancer patients1. These new recommendations meet the need of treatment specialists for staging that is responsive to the requirements of contemporary therapeutic planning. Differences in the two most widely used systems, those of the International Union Against Cancer (UICC)2–3 and the American Joint Committee on Cancer (AJCC)4–6 have been resolved and we now have recommendations for TNM classification and staging of lung cancer that are acceptable to the international scientific community. American Joint Committee on Cancer, Hawn Foundation of Texas, Herman Neel Hipp Fund for Research in Thoracic Surgery, Kelsey-Seybold Foundation grant 996, National Cancer Institute Division of Cancer Treatment (contract CA34503 Reference Center for Anatomic and Pathologic Classification of Lung Cancer of the Lung Cancer Study Group), Private Donors Fund for Research in Thoracic Surgery (Department of Thoracic Surgery, University of Texas System Cancer Center, M.D. Anderson Hospital).