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Toxicology Apr 2021The health hazard represented by the exposure to asbestos may also concern other minerals with asbestos-like crystal habit. One of these potentially hazardous minerals... (Comparative Study)
Comparative Study
The health hazard represented by the exposure to asbestos may also concern other minerals with asbestos-like crystal habit. One of these potentially hazardous minerals is fibrous glaucophane. Fibrous glaucophane is a major component of blueschist rocks of California (USA) currently mined for construction purposes. Dust generated by the excavation activities might potentially expose workers and the general public. The aim of this study was to determine whether fibrous glaucophane induces in vitro toxicity effects on lung cells by assessing the biological responses of cultured human pleural mesothelial cells (Met-5A) and THP-1 derived macrophages exposed for 24 h and 48 h to glaucophane fibres. Crocidolite asbestos was tested for comparison. The experimental configuration of the in vitro tests included a cell culture without fibres (i.e., control), cell cultures treated with 50 μg/mL (i.e., 15.6 μg/cm) of crocidolite fibres and 25-50-100 μg/mL (i.e., 7.8-15.6-31.2 μg/cm) of glaucophane fibres. Results showed that fibrous glaucophane may induce a decrease in cell viability and an increase in extra-cellular lactate dehydrogenase release in the tested cell cultures in a concentration dependent mode. Moreover, it was found that fibrous glaucophane has a potency to cause oxidative stress. The biological reactivity of fibrous glaucophane confirms that it is a toxic agent and, although it apparently induces lower toxic effects compared to crocidolite, exposure to this fibre may be responsible for the development of lung diseases in exposed unprotected workers and population.
Topics: Asbestos, Amphibole; Asbestos, Crocidolite; Cell Line; Cell Survival; Dose-Response Relationship, Drug; Epithelial Cells; Humans; Lung; Macrophages; Minerals; Oxidative Stress; Pleura; Time Factors
PubMed: 33675871
DOI: 10.1016/j.tox.2021.152743 -
The Lancet. Respiratory Medicine Jun 2024Most patients with pleural mesothelioma (PM) present with symptomatic pleural effusion. In some patients, PM is only detectable on the pleural surfaces, providing a... (Review)
Review
Most patients with pleural mesothelioma (PM) present with symptomatic pleural effusion. In some patients, PM is only detectable on the pleural surfaces, providing a strong rationale for intrapleural anticancer therapy. In modern prospective studies involving expert radiological staging and specialist multidisciplinary teams, the population incidence of stage I PM (an approximate surrogate of pleura-only PM) is higher than in historical retrospective series. In this Viewpoint, we advocate for the expansion of intrapleural trials to serve these patients, given the paucity of data supporting licensed systemic therapies in this setting and the uncertainties involved in surgical therapy. We begin by reviewing the unique anatomical and physiological features of the PM-bearing pleural space, before critically appraising the evidence for systemic therapies in stage I PM and previous intrapleural PM trials. We conclude with a summary of key challenges and potential solutions, including optimal trial designs, repurposing of indwelling pleural catheters, and new technologies.
Topics: Humans; Pleural Neoplasms; Mesothelioma; Pleura; Mesothelioma, Malignant; Antineoplastic Agents; Pleural Effusion, Malignant
PubMed: 38740045
DOI: 10.1016/S2213-2600(24)00111-5 -
Kyobu Geka. the Japanese Journal of... Sep 2021The decrease in the postoperative recurrence rate after thoracoscopic bullectomy for spontaneous pneumothorax is an issue that should be tackled even at this moment. We...
INTRODUCTION
The decrease in the postoperative recurrence rate after thoracoscopic bullectomy for spontaneous pneumothorax is an issue that should be tackled even at this moment. We presently make sure to do the reinforcement of the visceral pleura around between the staple line on bullectomy and the common sites of the new-born bullae such as apex, top site of S6, interlobar fissure to prevent postoperative recurrence.
PURPOSE
We evaluated the latest efficacy of preventing postoperative recurrence by widely covering the staple line and the common sites of the new-born bullae with a polyglycolic acid( PGA) sheet after bullectomy.
METHODS
Retrospective analyses were performed for 1,097 patients with spontaneous pneumothorax who received thoracoscopic bullectomy at our hospital between January 2011 and December 2020. The 1-year, 3-years, 5-years postoperative recurrence rates of 229 patients with spontaneous pneumothorax were respectively calculated with the Kaplan-Meier method.
RESULTS
The 1-year, 3-years, 5-years postoperative recurrence rates of spontaneous pneumothorax were 0.9%, 3.6%, 4.0%, respectively.
CONCLUSIONS
Combination treatment with bullectomy and wide coverage of the staple line and the common sites of the new-born bullae with the PGA sheet reduced satisfyingly postoperative recurrence rates of spontaneous pneumothorax.
Topics: Blister; Humans; Pleura; Pneumothorax; Recurrence; Retrospective Studies; Thoracic Surgery, Video-Assisted
PubMed: 34548455
DOI: No ID Found -
Journal of the Mechanical Behavior of... Jan 2022During thoracic operations, surgical staplers resect cancerous tumors and seal the spared lung. However, post-operative air leaks are undesirable clinical consequences:...
During thoracic operations, surgical staplers resect cancerous tumors and seal the spared lung. However, post-operative air leaks are undesirable clinical consequences: staple legs wound lung tissue. Subsequent to this trauma, air leaks from lung tissue into the pleural space. This affects the lung's physiology and patients' recovery. The objective is to biomechanically and visually characterize porcine lung tissue with and without staples in order to gain knowledge on air leakage following pulmonary resection. Therefore, a syringe pump filled with air inflates and deflates eleven porcine lungs cyclically without exceeding 10 cmHO of pressure. Cameras capture stereo-images of the deformed lung surface at regular intervals while a microcontroller simultaneously records the alveolar pressure and the volume of air pumped. The raw images are then used to compute tri-dimensional displacements and strains with the Digital Image Correlation method (DIC). Air bubbles originated at staple holes of inner row from exposed porcine lung tissue due to torn pleural on costal surface. Compared during inflation, left upper or lower lobe resections have similar compliance (slope of the pressure vs volume curve), which are 9% lower than healthy lung compliance. However, lower lobes statistically burst at lower pressures than upper lobes (p-value<0.046) in ex vivo conditions confirming previous clinical in vivo studies. In parallel, the lung deformed mostly in the vicinity of staple holes and presented maximum shear strain near the observed leak location. To conclude, a novel technique DIC provided concrete evidence of the post-operative air leaks biomechanics. Further studies could investigate causal relationships between the mechanical parameters and the development of an air leak.
Topics: Animals; Biomechanical Phenomena; Biophysics; Humans; Lung; Pleura; Surgical Staplers; Swine
PubMed: 34678619
DOI: 10.1016/j.jmbbm.2021.104883 -
Respiration; International Review of... 2021The detection of foreign bodies in the pleural cavity is rare and mostly consequent to iatrogenic or traumatic events. The migration of an inhaled foreign body from the...
The detection of foreign bodies in the pleural cavity is rare and mostly consequent to iatrogenic or traumatic events. The migration of an inhaled foreign body from the airways to the pleural space through a bronchopleural fistula is an exceptional event. We report a case of a pleural empyema consequent to an inhaled wooden skewer. CT scan and bronchoscopy were unable to identify the foreign body, due to its migration in the peripheral airways. The thin and pointed foreign body perforated the visceral pleural surface emerging in the pleural cavity.
Topics: Bronchial Fistula; Empyema, Pleural; Foreign Bodies; Humans; Pleura; Pleural Diseases
PubMed: 34134111
DOI: 10.1159/000516507 -
Current Problems in Cancer Dec 2023Pleural mesothelioma (PM) is a cancer of the pleural surface, which is aggressive and may be rapidly fatal. PM is a rare cancer worldwide, but is a relatively common... (Review)
Review
Pleural mesothelioma (PM) is a cancer of the pleural surface, which is aggressive and may be rapidly fatal. PM is a rare cancer worldwide, but is a relatively common disease in Turkey. Asbestos exposure is the main risk factor and the most common underlying cause of the disease. There have been significant improvements in diagnoses and treatments of many malignancies; however, there are still therapeutic challenges in PM. In this review, we aimed to increase the awareness of health care professionals, oncologists, and pulmonologists by underlining the unmet needs of patients with PM and by emphasizing the need for a multidisciplinary treatment and management of PM. After reviewing the general information about PM, we further discuss the treatment options for patients with PM using immunotherapy and offer evidence for improvements in the clinical outcomes of these patients because of these newer treatment modalities.
Topics: Humans; Immunotherapy; Mesothelioma; Pleura; Pleural Neoplasms; Turkey
PubMed: 37845104
DOI: 10.1016/j.currproblcancer.2023.101017 -
Praxis Nov 2022Pulmonary Opacities - What Lies Beneath? Abstract: Pulmonary opacities are among the most common findings that general practitioners and internists have to interpret in...
Pulmonary Opacities - What Lies Beneath? Abstract: Pulmonary opacities are among the most common findings that general practitioners and internists have to interpret in everyday life. Conventional chest x-rays are still important, but computed tomograms often provide additional information. Patient history, clinical examination but also additionally collected laboratory findings are important prerequisites for the interpretation of imaging studies. Likewise, radiological patterns should be recognized and correctly described. The density, distribution to one or both sides, basal or apical, unifocal or multifocal, also the involvement of the interstitial tissue, bronchioles, the alveolar space and pleura can provide decisive differential diagnostic information. Space-occupying or shrinking processes may be suspected on behalf of the course of pleural lines. Tumours may be differentiated from shrinking lung volume as seen in atelectasis by shift of the mediastinum or the shape of pleural lines. Occasionally control images can support the interpretation of the radiological results.
Topics: Humans; Pleura; Diagnostic Imaging
PubMed: 36415984
DOI: 10.1024/1661-8157/a003932 -
Annual International Conference of the... Jul 2020Asbestos is a toxic ore widely used in construction and commercial products. Asbestos tends to dissolve into fibers and after years inhaling them, these fibers calcify...
Asbestos is a toxic ore widely used in construction and commercial products. Asbestos tends to dissolve into fibers and after years inhaling them, these fibers calcify and form plaques on the pleura. Despite being benign, pleural plaques may indicate an immunologic deficiency or dysfunctional lung areas. We propose a pipeline for asbestos-related pleural plaque detection in CT images of the human thorax based on the following operations: lung segmentation, 3D patch selection along the pleura, a convolutional neural network (CNN) for feature extraction, and classification by support vector machines (SVM). Due to the scarcity of publicly available and annotated datasets of pleural plaques, the proposed CNN relies on architecture learning with random weights obtained by a PCA-based approach instead of using traditional filter learning by backpropagation. Experiments show that the proposed CNN can outperform its counterparts based on backpropagation for small training sets.
Topics: Asbestos; Humans; Neural Networks, Computer; Pleura; Pleural Diseases; Support Vector Machine
PubMed: 33018237
DOI: 10.1109/EMBC44109.2020.9176605 -
Journal of Cardiothoracic Surgery Feb 2023Solitary fibrous tumors (SFTs) are rare mesenchymal pleural neoplasms with an overall good prognosis and low recurrence rate if completely resected and if degree of... (Review)
Review
Solitary fibrous tumors (SFTs) are rare mesenchymal pleural neoplasms with an overall good prognosis and low recurrence rate if completely resected and if degree of differentiation is favorable. Within the last decade, advances in research have led to more reliable methods of differentiating SFTs from other soft tissue tumors. Historically, several markers were used to distinguish SFTs from similar tumors, but these markers had poor specificity. Recent evidence showed NAB2-STAT6 fusion gene to be a distinct feature of SFTs with 100% specificity and sensitivity. Surgical resection, with an emphasis on obtaining negative margins, is the mainstay of treatment for SFTs. Preoperative planning with detailed imaging is imperative to delineate the extent of disease and vascular supply. One important radiologic distinction to aid delineation of a pleural-based tumor compared to a pulmonary parenchymal-based tumor is the angle that the tumor forms with the chest wall, which is obtuse for a pleural-based tumor, and acute for tumors of the lung parenchyma. Often, preoperative tissue diagnosis is not available, and surgery is both diagnostic and curative. Intraoperatively, emphasis should be on complete resection with negative margins. SFTs are resected via several approaches: thoracotomy, sternotomy with the option of hemi-clamshell extension, video-assisted thoracoscopic surgery, and robotic approach, which is increasingly being used and is our preference. We recommend a minimally invasive approach for most lesions, and have resected SFTs of the pleura that are up to 12 cm with the robotic approach. However, the current literature often cites 5 cm as the cut off for an open thoracotomy. Nevertheless, even with larger tumors, a minimally invasive robotic approach is our preference and practice. For giant SFTs (> 20 cm), an open approach may be preferable. Multiple thoracotomies and rib resection may be required to gain adequate exposure and ensure complete resection in these tumors. However, it is noteworthy that most of these tumors have a soft consistency and thus, once bagged, can easily be removed minimally invasively, and thus minimally invasive approach should not be completely ruled out. Recurrence in SFTs usually results from incomplete resection and redo surgery may portend a favorable prognosis.
Topics: Humans; Pleura; Severe Fever with Thrombocytopenia Syndrome; Solitary Fibrous Tumors; Pleural Neoplasms; Prognosis
PubMed: 36823638
DOI: 10.1186/s13019-023-02168-7 -
Multimedia Manual of Cardiothoracic... Aug 2023This video tutorial is a step-by-step demonstration of the indwelling pleural catheter insertion technique in a patient who was diagnosed with malignant pleural...
This video tutorial is a step-by-step demonstration of the indwelling pleural catheter insertion technique in a patient who was diagnosed with malignant pleural effusions due to multiple metastases. Placing an indwelling pleural catheter is a novel method to treat chronic pleural effusions, especially secondary to malignancies. This method is particularly useful in patients with a trapped lung or with reduced life expectancy in whom more-invasive procedures are contraindicated. Indwelling pleural catheters are well tolerated.
Topics: Humans; Pleura; Pleural Effusion, Malignant; Catheters
PubMed: 37615545
DOI: 10.1510/mmcts.2023.045