Thoracoscopy: origins revisited

The ways in which thoracoscopy has evolved wonderfully illustrate how a diagnostic and therapeutic technique can transcend a particular medical or surgical subspecialty. In this review, an in-depth history is provided to enable readers to better understand the nature of minimally invasive endoscopic pleural imaging techniques.     

Proof‐of‐concept evidence for trimodal simultaneous investigation of human brain function

The link between spatial (where) and temporal (when) aspects of the neural correlates of most psychological phenomena is not clear. Elucidation of this relation, which is crucial to fully understand human brain function, requires integration across multiple brain imaging modalities and cognitive tasks that reliably modulate the engagement of the brain systems of interest. By overcoming the methodological challenges posed by simultaneous recordings, the present report provides proof‐of‐concept evidence for a novel approach using three complementary imaging modalities: functional magnetic resonance imaging (fMRI), event‐related potentials (ERPs), and event‐related optical signals (EROS). Using the emotional oddball task, a paradigm that taps into both cognitive and affective aspects of processing, we show the feasibility of capturing converging and complementary measures of brain function that are not currently attainable using traditional unimodal or other multimodal approaches. This opens up unprecedented possibilities to clarify spatiotemporal integration of brain function.     

Predicting mental quality of life in breast cancer survivors using comparison participants

The objective of this research is to propose a comprehensive model for the prediction of long-term mental health in breast cancer survivors diagnosed 5 to 15 years earlier, compared to female participants referring to the most stressful event that occurred within the last 20 years. Nearly 300 survivors and 132 comparison participants were consulted using a questionnaire, which evaluated personality variables, transactional variables, and current mental quality of life. Structural equation modeling was used. The transactional proposed model was able to account for long-term mental health variance in both groups but was more relevant to women with breast cancer.     

Analytical methods used in conjunction with solid-phase microextraction: a review of recent bioanalytical applications

Integration of sampling and sample preparation with various analytical instruments is a highly desirable feature for any analytical method. This is most conveniently achieved by using microextraction techniques or various microdevices. Among these techniques, solid-phase microextraction (SPME) is particularly remarkable due to its simplicity and effectiveness. This review discusses the most recent applications of SPME in bioanalysis, grouped according to the analytical instrument that SPME is coupled to. It is shown that one of the most important aspects of such analytical methods is the ability of SPME to perform direct and selective extraction of analytes from complex biological samples. By far, the most popular method continues to be SPME coupled to GC. Nevertheless, the last 2 years have witnessed significant advances in other areas, such as successful automation of SPME coupled to liquid chromatography and the development of new coatings suitable for direct extraction from biological samples. Furthermore, a few bioanalytical applications based on direct coupling of SPME to MS, ion mobility spectrometry, CE and analytical chemiluminescence have been reported.     

Opposing influences of emotional and non-emotional distracters upon sustained prefrontal cortex activity during a delayed-response working memory task

Performance in delayed-response working memory (WM) tasks is typically associated with sustained activation in the dorsolateral prefrontal cortex (dlPFC) that spans the delay between the memoranda and the memory probe. Recent studies have demonstrated that novel distracters presented during the delay interval both affect sustained activation and impair WM performance. However, the effect of the performance-impairing distracters upon sustained dlPFC delay activity was related to the characteristics of the distracters: memoranda-confusable distracters increased delay activity, whereas memoranda-nonconfusable emotional distracters decreased delay activity. Because these different effects were observed in different studies, it is possible that different dlPFC regions were involved and the paradox is more apparent than real. To investigate this possibility, event-related fMRI data were recorded while subjects performed a WM task for faces with memoranda-confusable (novel faces) and memoranda-nonconfusable emotional (novel scenes) distracters presented during the delay interval. Consistent with previous findings, confusable face distracters increased dlPFC delay activity, while nonconfusable emotional distracters decreased dlPFC delay activity, and these opposing effects modulated activity in the same dlPFC regions. These results provide direct evidence that specific regions of the dlPFC are generally involved in mediating the effects of distraction, while showing sensitivity to the nature of distraction. These findings are relevant for understanding alterations in the neural mechanisms associated with both general impairment of cognitive control and with specific impairment in the ability to control emotional distraction, such as those observed in aging and affective disorders, respectively.     

Systematic extended right posterior sectionectomy: a safe and effective alternative to right hepatectomy

BACKGROUND: A surgical approach based on ultrasound-guided hepatectomy might minimize the need for major resection, whose rates of morbidity and mortality are not negligible. Right hepatectomy (RH) is traditionally performed in cases of vascular invasion of the right hepatic vein with multiple tumors in the right posterior section, and/or of the right posterior portal branch (P6-7) with tumor in contact with right anterior portal branch (P5-8). We herein describe an alternative approach to RH consisting in ultrasound-guided systematic extended right posterior hepatic sectionectomy (SERPS). METHODS: Among 207 consecutive patients who underwent hepatectomies, 21 (10%) underwent SERPS. Median age was 67 years (range, 48-79). There were 13 men and 8 women. Ten (48%) patients had hepatocellular carcinoma; 11 (52%) had colorectal liver metastases. Median tumor number was 2 (range, 1-15); median tumor size was 4.5 cm (range, 2.5-20). Ten (48%) patients had cirrhosis, 8 (38%) had steatosis, and 3 (16%) had normal liver. Surgical strategy was based on tumor-vessels relationship at intraoperative ultrasonography (IOUS) and on findings at color-Doppler IOUS. RESULTS: In-hospital and 90-days mortality were nil. Major and minor morbidity occurred in 3 (14%) and 2 (9.5%) patients, respectively. No patients were reoperated because of complications. Blood transfusions were given to 2 (9.5%) patients. After a median follow-up of 21 months, no local recurrence was observed. CONCLUSIONS: IOUS-guided SERPS is feasible, safe, and effective. It should be applied whenever possible as alternative resection to RH to maximize liver parenchymal sparing.     

Laparoscopic transection and immediate repair of obturator nerve during pelvic lymphadenectomy

Radical pelvic surgery including pelvic lymphadenectomy in the obturator fossa has become a routine endoscopically performed procedure in patients with gynecologic cancer. Nerve injury during these procedures is rare. However, to choose the best surgical procedure, the surgeon must be aware of the anatomical landmarks of the obturator fossa and of various injury mechanisms. Herein is presented the case of obturator nerve transection during laparoscopic pelvic lymph node dissection, radical vulvectomy, and inguinal lymphadenectomy and its immediate laparoscopic repair in a 56-year-old patient.