The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Neuropilin-2b facilitates resistance to tyrosine kinase inhibitors in non-small cell lung cancer.
Innate and acquired resistance is the principle factor limiting the efficacy of tyrosine kinase inhibitors in lung cancer. We have observed a dramatic upregulation of the cell surface co-receptor neuropilin-2b in lung cancers clinically treated with tyrosine kinase inhibitors correlating with acquired resistance. We hypothesize that neuropilin-2b plays a functional role in acquired tyrosine kinase inhibitor resistance. ⋯ Neuropilin-2b facilitates non-small cell lung cancer resistance to tyrosine kinase inhibitors, and this biological effect relates to AKT activation. Neuropilin-2b GSK3β interactions appear to be essential for PTEN degradation and AKT activation in lung cancer cells. Disruption of the neuropilin-2b GSK3β interaction may represent a novel treatment strategy to preserve sensitivity to tyrosine kinase inhibitors in non-small cell lung cancer.
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Computed tomography density is not associated with pathological tumor invasion for pure ground-glass nodules.
Pure ground-glass nodules are considered to be radiologically noninvasive in lung adenocarcinoma. However, some pure ground-glass nodules are found to be invasive adenocarcinoma pathologically. This study aims to identify the computed tomography parameters distinguishing invasive adenocarcinoma from adenocarcinoma in situ and minimally invasive adenocarcinoma. ⋯ In patients with pure ground-glass nodules, computed tomography size was the only radiographic parameter associated with tumor invasion. Measuring computed tomography density provided no advantage in differentiating invasive adenocarcinoma from adenocarcinoma in situ and minimally invasive adenocarcinoma.
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Pulsatile ventricular assist device as a bridge to transplant for the early high-risk single-ventricle physiology.
The use of ventricular assist devices (VADs) as a bridge-to-transplant in patients with single-ventricle physiology post-stage one palliation has been associated with poor outcomes. We describe our center's successful experience in the use of paracorporeal pulsatile VADs in the palliation of high-risk single ventricle physiology before or after the first stage of palliation with an impetus on pre-palliation implant. ⋯ The use of pulsatile paracorporeal VADs is a feasible option as a bridge-to-transplant in the peri-stage one high-risk single ventricle.
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J. Thorac. Cardiovasc. Surg. · Aug 2021
Progression in Fontan conduit stenosis and hemodynamic impact during childhood and adolescence.
To characterize changes in Fontan conduit size over time and determine if cross-sectional area (CSA) affects cardiac output, pulmonary artery growth, and exercise capacity. ⋯ Fontan conduit CSA decreases as early as 6 months post-Fontan. The minimum Fontan CSA/BSA was not associated with cardiac index or pulmonary artery size but did correlate with % predicted peak oxygen consumption.