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Archivos de Bronconeumologia Dec 2017
Topics: Humans; Pleura; Pleural Diseases; Ultrasonography
PubMed: 28684132
DOI: 10.1016/j.arbres.2017.05.028 -
Journal of Vascular Surgery. Venous and... May 2020This study evaluated swine and bovine pulmonary visceral pleura (PVP) as a vascular patch. Venous patches are frequently used in surgery for repair or reconstruction of...
OBJECTIVE
This study evaluated swine and bovine pulmonary visceral pleura (PVP) as a vascular patch. Venous patches are frequently used in surgery for repair or reconstruction of veins. Autologous patches are often limited by the number and dimension of donor tissue and can result in donor complications. Bovine pericardium is the most common heterologous patch used by vascular surgeons. Researchers, however, are continually seeking to improve heterologous and synthetic patches for improved outcome.
METHODS
The PVP was peeled from swine and bovine lungs and cross-linked with glutaraldehyde. After sterilization and rinsing, the PVP patches were implanted in the jugular vein (10 × 35 mm) of pigs and dogs. Patency was evaluated by ultrasound, and animals were euthanized at 2 and 4 months. Neoendothelium and neomedia were evaluated by histologic analysis.
RESULTS
The jugular vein patched by PVP in pigs and dogs remained patent at 2 and 4 months with no adhesions, inflammation, or aneurysm in the patches. The biomarkers of endothelial cells-factor VIII, platelet/endothelial cell adhesion molecule 1, and endothelial nitric oxide synthase-were detected in the neoendothelial cells. The expression of vascular smooth muscle cell (VSMC) α-actin was robust in the neomedia at 2 and 4 months. Neomedia composed of VSMCs developed to nearly double the thickness of adjacent jugular vein. The circumferential orientation of VSMCs in neomedia further increased in the 4-month group.
CONCLUSIONS
The cross-linked swine and bovine PVP patch has a nonthrombogenic surface that maintains patency. The PVP patch may overcome the pitfall of compliance mismatch of synthetic patches. The proliferation of vascular cells assembled in the neoendothelium and neomedia in the patches may support long-term patency.
Topics: Animals; Autografts; Bioprosthesis; Blood Vessel Prosthesis; Blood Vessel Prosthesis Implantation; Cattle; Cross-Linking Reagents; Dogs; Fixatives; Glutaral; Heterografts; Jugular Veins; Materials Testing; Neointima; Pleura; Swine; Swine, Miniature; Time Factors; Vascular Patency; Vascular Remodeling
PubMed: 31837973
DOI: 10.1016/j.jvsv.2019.09.011 -
Seminars in Diagnostic Pathology Nov 2020This special issue is dedicated to the pathologic diagnosis of commonly encountered pulmonary hematolymphoid tumors and the reactive mimickers. The articles focused on...
This special issue is dedicated to the pathologic diagnosis of commonly encountered pulmonary hematolymphoid tumors and the reactive mimickers. The articles focused on the interesting topics of primary malignant hematolymphoid diseases of the lung and pleura. We hope this update is educational for general surgical pathologists and hematopathologists when dealing with challenging pulmonary lesions of lymphoid infiltrates in their daily practices.
Topics: Humans; Lung; Lung Neoplasms; Pleura
PubMed: 32564902
DOI: 10.1053/j.semdp.2020.05.004 -
Kyobu Geka. the Japanese Journal of... Jul 2021The adhesion between the visceral and parietal pleura makes video-assisted thoracoscopic surgery (VATS) difficult or impossible. When performing VATS without conversion...
The adhesion between the visceral and parietal pleura makes video-assisted thoracoscopic surgery (VATS) difficult or impossible. When performing VATS without conversion to thoracotomy due to pleural adhesion, it is important to( ⅰ) evaluate the presence and extent of the adhesion preoperatively, (ⅱ) carefully perform detachment, and( ⅲ) adequately repair the injured visceral pleura. We evaluate visceral sliding with the help of chest ultrasonography and plan the best approach to make utility inci-sions, camera port, and third-port incisions. Considering the difficulty in repairing the injured visceral pleura under VATS, we perform extra-pleural detachment of adhesions around the injured visceral pleura, which can facilitate the repair of the pleural injury. For repairing pleural injury, we use free mediastinal fat tissue as biological pledgets to support suturing. In this report, we present the approaches and techniques we follow to perform VATS for patients with pleural adhesion.
Topics: Humans; Pleura; Pleural Diseases; Thoracic Surgery, Video-Assisted; Thoracotomy; Tissue Adhesions
PubMed: 34193781
DOI: No ID Found -
Scientific Reports May 2021Birt-Hogg-Dubé syndrome (BHDS), an autosomal dominant inheritance disease caused by folliculin (FLCN) mutations, is associated with lung cysts and spontaneous...
Birt-Hogg-Dubé syndrome (BHDS), an autosomal dominant inheritance disease caused by folliculin (FLCN) mutations, is associated with lung cysts and spontaneous pneumothorax. The possibility of FLCN haploinsufficiency in pleural mesothelial cells (PMCs) contributing to development of pneumothorax has not yet been clarified. Electron microscopy revealed exposed intercellular boundaries between PMCs on visceral pleura and decreased electron density around the adherens junctions in BHDS. To characterize cellular function of PMCs in BHDS patients (BHDS-PMCs), during surgery for pneumothorax, we established the flow cytometry-based methods of isolating high-purity PMCs from pleural lavage fluid. BHDS-PMCs showed impaired cell attachment and a significant decrease in proliferation and migration, but a significant increase in apoptosis compared with PMCs from primary spontaneous pneumothorax (PSP) patients (PSP-PMCs). Microarray analysis using isolated PMCs revealed a significant alteration in the expression of genes belonging to Gene Ontology terms "cell-cell adhesion junction" and "cell adhesion molecule binding". Gene set enrichment analysis demonstrated that CDH1, encoding E-cadherin, was identified in the down-regulated leading edge of a plot in BHDS-PMCs. AMPK and LKB1 activation were significantly impaired in BHDS-PMCs compared with PSP-PMCs. Our findings indicate that FLCN haploinsufficiency may affect the E-cadherin-LKB1-AMPK axis and lead to abnormal cellular function in BHDS-PMCs.
Topics: Adult; Apoptosis; Birt-Hogg-Dube Syndrome; Bronchoalveolar Lavage Fluid; Cell Movement; Cell Proliferation; Epithelial Cells; Female; Gene Expression Profiling; Gene Expression Regulation; Haploinsufficiency; Humans; Male; Microscopy, Electron; Middle Aged; Oligonucleotide Array Sequence Analysis; Pleura; Primary Cell Culture; Proto-Oncogene Proteins; Tumor Suppressor Proteins; Young Adult
PubMed: 34031471
DOI: 10.1038/s41598-021-90184-9 -
The Thoracic and Cardiovascular Surgeon Aug 2017Sericin is a natural, gum-like, macromolecule protein, synthesized from silkworms for the formation of cocoon shells. The aim of the present study is to describe the...
Sericin is a natural, gum-like, macromolecule protein, synthesized from silkworms for the formation of cocoon shells. The aim of the present study is to describe the effects of sericin when used for pleurodesis and/or as tissue glue. Adult, male, 12-week-old Wistar albino rats, weighing 257 to 395 g were used in the present study ( = 12). The animals were randomly divided into two equal groups as the sericin and the control group. After intramuscular administration of the anesthetic agent, the rats were intubated and mechanically ventilated. A left thoracotomy was performed and 30 mg sericin powder was instilled into the thoraxes of the sericin group. The remaining rats were allocated to a sham thoracotomy group. The animals were housed in individual cages, fed ad-libitum, and sacrificed 8 days after. After sacrifice, the left hemithoraxes were removed en bloc and underwent histopathologic examination. Masson trichrome staining was applied on the visceral pleura sections of all the animals. Each animal specimen ( = 6, 100%) in the control group showed minimal collagen deposition, while only one rat (16.67%) in the sericin group had minimal collagen deposition. However, in the sericin group, five animals (83.33%) showed dense collagen deposition, fibroblastic activity, and fibrosis. According to the test method, independent -test, developing fibroblastic activity and fibrosis are statistically significant between the two groups ( < 0.01). There were no foreign-body reactions and no evidence of biological glue on the specimens in the sericin group. The rats in the sericin group had lower inflammatory reactions compared with those in the control group. Emphysema was observed in two rats (33.33%) in the sericin group and in four rats (66.67%) in the control group. Therefore, sericin was found to be associated with an increase in fibroblastic activity and fibrosis in visceral pleura without exerting any adverse effect on the lung parenchyma. Sericin is a new and researchable protein for chest diseases and thoracic surgery. To develop an effect of dense collagen deposition, fibroblastic activity, and fibrosis in the visceral pleura, without significant adverse effects, is remarkable. Therefore, sericin may be useful as a pleurodesis agent or natural biological glue in the future. Sericin treatment can add value to the disciplines of pulmonology and thoracic surgery.
Topics: Animals; Collagen; Fibroblasts; Fibrosis; Male; Pleura; Pleurodesis; Powders; Rats, Wistar; Sericins; Thoracotomy; Tissue Adhesives; Wound Healing
PubMed: 26757213
DOI: 10.1055/s-0035-1570373 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2024Aim: data study on the results of treatment of acute non-specific purulent-destructive pleura diseases with the purpose of further improvement of its results on the... (Review)
Review
OBJECTIVE
Aim: data study on the results of treatment of acute non-specific purulent-destructive pleura diseases with the purpose of further improvement of its results on the basis of improvement of diagnostics, identification of factors of disease prognosis and by implementing differential tactics of surgical treatment with the use of minimally invasive interventions.
PATIENTS AND METHODS
Materials and Methods: We have studied modern literary sources on the topic of current trends in the treatment of acute pleural empyema and its complications. The studied material is summarized and presented in the form of a literature review in this article.
CONCLUSION
Conclusions: These issues cannot be considered to be completely solved and require further study. Everything mentioned above dictates the search of new effective methods of the treatment of the mentioned pathology and proves the relevance of the theme. The outlined information highlights the necessity of improvement of surgical tactics in patients with pleural empyema.
Topics: Humans; Pleura; Empyema, Pleural; Drainage
PubMed: 38592997
DOI: 10.36740/WLek202402121 -
Intensive Care Medicine Jul 2016On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical... (Review)
Review
PURPOSE
On a regular basis, the intensivist encounters the patient who is difficult to wean from mechanical ventilatory support. The causes for failure to wean from mechanical ventilatory support are often multifactorial and involve a complex interplay between cardiac and pulmonary dysfunction. A potential application of point of care ultrasonography relates to its utility in the process of weaning the patient from mechanical ventilatory support.
METHODS
This article reviews some applications of ultrasonography that may be relevant to the process of weaning from mechanical ventilatory support.
RESULTS
The authors have divided these applications of ultrasonography into four separate categories: the assessment of cardiac, diaphragmatic, and lung function; and the identification of pleural effusion; which can all be evaluated with ultrasonography during a dynamic process in which the intensivist is uniquely positioned to use ultrasonography at the point of care.
CONCLUSIONS
Ultrasonography may have useful application during the weaning process from mechanical ventilatory support.
Topics: Diaphragm; Heart; Humans; Lung; Pleura; Point-of-Care Systems; Ultrasonography; Ventilator Weaning
PubMed: 26951426
DOI: 10.1007/s00134-016-4245-3 -
Current Opinion in Pulmonary Medicine Jul 2017To review the latest developments in surgery for malignant pleural mesothelioma both in patient selection, surgical technique, and strategy. (Review)
Review
PURPOSE OF REVIEW
To review the latest developments in surgery for malignant pleural mesothelioma both in patient selection, surgical technique, and strategy.
RECENT FINDINGS
The International Association for the Study of Lung Cancer mesothelioma staging project has produced data to inform the 8th tumour node metastasis revision. The difficulty in clinical N staging and clinical T staging are highlighted and the importance of tumour volume is recognized. New imaging techniques can be utilized to assess tumour volume. The transition from extrapleural pneumonectomy to lung-sparing pleurectomy/decortication has extended the role of cancer-directed surgery into a more elderly population. More aggressive multimodality regimes, including induction radiotherapy are available to a selected population and adjuvant radiotherapy and chemotherapy are feasible in the elderly majority. Additional chemotherapy should not be delayed in those with poorer prognosis node positive, nonepithelioid disease.
SUMMARY
Radical surgery for malignant pleural mesothelioma can achieve significant survival when targeted in those with the best prognosis by careful staging. It can be made more accessible by lung preservation without compromising outcome. It should be part of multimodality therapy.
Topics: Combined Modality Therapy; Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Neoplasm Staging; Patient Selection; Pleura; Pleural Neoplasms; Pneumonectomy; Radiotherapy, Adjuvant; Thoracic Surgical Procedures; Treatment Outcome
PubMed: 28590338
DOI: 10.1097/MCP.0000000000000389 -
International Journal of Clinical... Jul 2021Although most common adverse events associated with dry needling can be considered minor, serious adverse events including induced pneumothorax cannot be excluded, and...
BACKGROUND
Although most common adverse events associated with dry needling can be considered minor, serious adverse events including induced pneumothorax cannot be excluded, and safety instructions for reducing the risk of pleura puncture are needed.
OBJECTIVE
To investigate if anthropometric features can predict the rhomboid major muscle and pleura depth in a sample of healthy subjects to avoid the risk of pneumothorax during dry needling.
METHODS
A diagnostic study was conducted on 59 healthy subjects (52.5% male) involving a total of 236 measurements (both sides in maximum inspiration and expiration), to calculate the accuracy of a prediction model for both pleura and rhomboid depth, as assessed with ultrasound imaging, based on sex, age, height, weight, body mass index (BMI), breathing and chest circumference. A correlation matrix and a multiple linear regression analyses were used to detect those variables contributing significantly to the variance in both locations.
RESULTS
Men showed greater height, weight, BMI, thorax circumference and skin-to-rhomboid, rhomboid-to-pleura and skin-to-pleura distances (P < .001). Sex, BMI, and thorax circumference explained 51.5% of the variance of the rhomboid (P < .001) and 69.7% of pleura (P < .001) depth limit. In general, inserting a maximum length of 19 mm is recommended to reach the deep limit of rhomboid major decreasing the risk of passing through the pleura.
CONCLUSION
This study identified that gender, BMI and thorax circumference can predict both rhomboid and pleura depth, as assessed with ultrasonography, in healthy subjects. Our findings could assist clinicians in the needle length election in avoiding the risk of induced pneumothorax during dry needling.
Topics: Dry Needling; Female; Humans; Male; Pleura; Pneumothorax; Superficial Back Muscles; Ultrasonography
PubMed: 33759289
DOI: 10.1111/ijcp.14176