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Environmental Health Perspectives Sep 1997In the present subchronic study, we compared pleural inflammation, visceral pleural collagen deposition, and visceral and parietal pleural mesothelial cell proliferation... (Comparative Study)
Comparative Study
In the present subchronic study, we compared pleural inflammation, visceral pleural collagen deposition, and visceral and parietal pleural mesothelial cell proliferation in rats and hamsters identically exposed to a kaolin-based refractory ceramic fiber, (RCF)-1 by nose-only inhalation exposure, and correlated the results to translocation of fibers to the pleural cavity. Fischer 344 rats and Syrian golden hamsters were exposed to 650 fibers/cc of RCF-1, for 4 hr/day, 5 days/week for 12 weeks. Following 4 and 12 weeks of exposure, and after a 12-week recovery period, pleural lavage fluid was analyzed for cytologic and biochemical evidence of inflammation. Visceral and parietal pleural mesothelial cell proliferation was assessed by immunocytochemical detection of bromodeoxyuridine incorporation. Pleural collagen was quantitated using morphometric analysis of lung sections stained with Sirius Red. Fiber-exposed rats and hamsters had qualitatively similar pleural inflammation at each time point. Mesothelial cell proliferation was more pronounced in hamsters than in rats at each time point and at each site. In both species, the mesothelial cell labeling index was highest in the parietal pleural mesothelial cells lining the surface of the diaphragm at each time point. Hamsters but not rats had significantly elevated collagen in the visceral pleura at the 12-week postexposure time point. Fibers were found in the pleural cavities of both species at each time point. These fibers were generally short and thin. These results suggest that mesothelial cell proliferation and fibroproliferative changes in the pleura of rodents following short-term inhalation exposure are associated with fiber translocation to the pleura and may be predictive of chronic pleural disease outcomes following long-term exposure.
Topics: Administration, Inhalation; Animals; Cell Division; Ceramics; Collagen; Cricetinae; Male; Mesocricetus; Mice; Mice, Inbred Strains; Mineral Fibers; Pleura; Rats; Rats, Inbred F344; Species Specificity
PubMed: 9400725
DOI: 10.1289/ehp.97105s51209 -
Journal of Cardiothoracic Surgery Apr 2023The high resolution of computed tomography has found the pulmonary ligaments that consists of a double serous layer of visceral pleura, forms the intersegmental septum,...
BACKGROUND
The high resolution of computed tomography has found the pulmonary ligaments that consists of a double serous layer of visceral pleura, forms the intersegmental septum, and enters the lung parenchyma. This study aimed to investigate the clinical feasibility of thoracoscopic segmentectomy (TS) of the lateral basal segment (S9), posterior basal segment (S10), and both through the pulmonary ligament (PL).
METHODS
Between February 2009 and November 2021, 542 patients underwent segmentectomy for malignant lung tumors at Tokyo Women's Medical University Hospital (Tokyo, Japan). This study included 51 patients. Among them, 40 underwent a complete TS of the S9, S10, or both by the PL approach (PL group), and the remaining 11 by the interlobar fissure approach (IF group).
RESULTS
Patients' characteristics did not significantly differ between the two groups. In the PL group, 34 underwent video-assisted thoracoscopic surgery (VATS), and 6 underwent robot-assisted thoracoscopic surgery. In the IF group, all 11 underwent VATS. Operation duration, estimated blood loss, and postoperative complication frequency were not significantly different between these groups, but the maximum tumor diameter showed a significant difference.
CONCLUSIONS
Complete TS of the S9, S10, and both through the PL is a reasonable option for tumors located in such segments. This approach is a feasible option for performing TS.
Topics: Humans; Female; Retrospective Studies; Pneumonectomy; Pleura; Lung Neoplasms; Thoracic Surgery, Video-Assisted; Ligaments
PubMed: 37069664
DOI: 10.1186/s13019-023-02256-8 -
The European Respiratory Journal Jan 1997
Topics: Humans; Lung; Lymphatic System; Pleura; Pleural Diseases; Pleural Effusion; Pressure
PubMed: 9032482
DOI: 10.1183/09031936.97.10010002 -
Medicine Aug 2022The effectiveness of thoracoscopic biopsy as a diagnostic method for pleural diseases has been reported; however, obtaining a sufficient specimen size is sometimes...
The effectiveness of thoracoscopic biopsy as a diagnostic method for pleural diseases has been reported; however, obtaining a sufficient specimen size is sometimes difficult. Therefore, an ancillary technique, the precut technique using an injection needle, was devised to address this problem. This study aimed to evaluate the effectiveness and safety of the novel precut technique in patients with undiagnosed pleural effusion. This retrospective study included 22 patients who underwent pleural biopsy using the precut technique to examine exudative pleural effusion of unknown etiology. Thoracoscopy was performed under local anesthesia. The biopsy procedure was performed as follows: a needle was inserted into the pleura around the lesion using a semiflexible thoracoscope; the needle was positioned to make an incision in the pleura while injecting 1% lidocaine with epinephrine and lifting the pleura from the fascia; 2 or 3 precut incision lines were arranged in a triangle; and the specimen was obtained from the parietal pleura using forceps or a cryoprobe. Patient data including age, number of biopsies, biopsy specimen size, pathological and final diagnosis, and postoperative complications were examined. All patients were male with an average age of 74 years. Pleural effusion was found on the right and left sides in 16 and 6 patients, respectively. The average major axis of the biopsy specimens was 18 mm (range, 10-30 mm), which was sufficient to establish a pathological diagnosis. Only 1 patient experienced minor temporal bleeding as a complication. The precut technique enabled the procurement of specimens sufficient in size for pleural biopsy.
Topics: Aged; Biopsy; Female; Humans; Male; Pleura; Pleural Diseases; Pleural Effusion; Retrospective Studies; Thoracoscopy
PubMed: 35945762
DOI: 10.1097/MD.0000000000029377 -
The Clinical Respiratory Journal Dec 2023Parietal pleurectomy with bullectomy has been established as an effective method for preventing the recurrence of primary spontaneous pneumothorax (PSP). Our center...
INTRODUCTION
Parietal pleurectomy with bullectomy has been established as an effective method for preventing the recurrence of primary spontaneous pneumothorax (PSP). Our center introduced enhanced technical measures in uniportal thoracoscopic parietal pleurectomy with bullectomy for patients with PSP, aiming to document our initial experience and assess the procedure's effectiveness in preventing the recurrence of PSP.
METHODS
We analyzed the clinical data of 86 patients with PSP who underwent the improved uniportal thoracoscopic parietal pleurectomy with bullectomy between July 2019 and August 2022. During the procedure, the parietal pleura above the second intercostal space was stripped but not removed. Instead, it was retained in the thoracic cavity using a piece of pedunculated pleura. Subsequently, the stumps of the lung were covered by the preserved parietal pleura.
RESULTS
The results of the study showed that the mean operative time was 59.87 ± 16.93 min, and the postoperative drainage duration averaged 3.94 ± 2.17 days. The mean intraoperative blood loss was 24.33 ± 48.91 ml, and the mean postoperative drainage volume was 289.00 ± 170.03 ml. Prolonged air leakage for more than 5 days was observed in five patients (5.81%), but no other postoperative complications were recorded. During the follow-up, one patient (1.16%) experienced a recurrence of pneumothorax.
CONCLUSIONS
The perioperative results of bullectomy with the improved pleurectomy technique are deemed satisfactory. The various technical steps attempted at our center are found to be feasible and safe, and they may contribute to reducing the rates of recurrence in PSP.
Topics: Humans; Pneumothorax; Retrospective Studies; Pleura; Thoracic Surgical Procedures; Postoperative Complications; Recurrence; Thoracic Surgery, Video-Assisted; Treatment Outcome
PubMed: 38043134
DOI: 10.1111/crj.13722 -
The Journal of Thoracic and... Apr 2015
Topics: Animals; Drug Combinations; Female; Fibrinogen; Pleura; Pneumothorax; Thrombin; Wound Healing
PubMed: 25680747
DOI: 10.1016/j.jtcvs.2015.01.018 -
Thorax Mar 1986
Review
Topics: Cell Division; Eosinophils; Epithelium; Exudates and Transudates; Humans; Lymphocytes; Mesothelioma; Neutrophils; Pleura; Pleural Effusion; Pleurisy; Pulmonary Fibrosis
PubMed: 3520935
DOI: 10.1136/thx.41.3.176 -
Zhongguo Fei Ai Za Zhi = Chinese... Dec 2022Visceral pleural invasion (VPI) is one of the negative prognostic factors of non-small cell lung cancer (NSCLC). With the popularization of computed tomography (CT)... (Review)
Review
Visceral pleural invasion (VPI) is one of the negative prognostic factors of non-small cell lung cancer (NSCLC). With the popularization of computed tomography (CT) screening for lung cancer, more and more ground-glass nodule (GGN) have been found. However, it remains unclear whether the relationship between the pleural deformation of lung cancer manifesting as ground-glass opacity (GGO) and VPI affects the effect of sub-lobectomy, which is reviewed in this paper. .
Topics: Humans; Lung Neoplasms; Carcinoma, Non-Small-Cell Lung; Retrospective Studies; Pleura; Tomography, X-Ray Computed; Prognosis; Neoplasm Invasiveness
PubMed: 36617476
DOI: 10.3779/j.issn.1009-3419.2022.102.50 -
Diagnostic and Interventional Radiology... Mar 2023Preoperative prediction of visceral pleural invasion (VPI) is important because it enables thoracic surgeons to choose appropriate surgical plans. This study aimed to...
Multivariate analysis based on the maximum standard unit value of F-fluorodeoxyglucose positron emission tomography/computed tomography and computed tomography features for preoperative predicting of visceral pleural invasion in patients with subpleural clinical stage IA peripheral lung...
PURPOSE
Preoperative prediction of visceral pleural invasion (VPI) is important because it enables thoracic surgeons to choose appropriate surgical plans. This study aimed to develop and validate a multivariate logistic regression model incorporating the maximum standardized uptake value (SUV) and valuable computed tomography (CT) signs for the non-invasive prediction of VPI status in subpleural clinical stage IA lung adenocarcinoma patients before surgery.
METHODS
A total of 140 patients with subpleural clinical stage IA peripheral lung adenocarcinoma were recruited and divided into a training set (n = 98) and a validation set (n = 42), according to the positron emission tomography/CT examination temporal sequence, with a 7:3 ratio. Next, VPI-positive and VPI-negative groups were formed based on the pathological results. In the training set, the clinical information, the SUV, the relationship between the tumor and the pleura, and the CT features were analyzed using univariate analysis. The variables with significant differences were included in the multivariate analysis to construct a prediction model. A nomogram based on multivariate analysis was developed, and its predictive performance was verified in the validation set.
RESULTS
The size of the solid component, the consolidation-to-tumor ratio, the solid component pleural contact length, the SUVmax, the density type, the pleural indentation, the spiculation, and the vascular convergence sign demonstrated significant differences between VPI-positive (n = 40) and VPI-negative (n = 58) cases on univariate analysis in the training set. A multivariate logistic regression model incorporated the SUV [odds ratio (OR): 1.753, = 0.002], the solid component pleural contact length (OR: 1.101, = 0.034), the pleural indentation (OR: 5.075, = 0.041), and the vascular convergence sign (OR: 13.324, = 0.025) as the best combination of predictors, which were all independent risk factors for VPI in the training group. The nomogram indicated promising discrimination, with an area under the curve value of 0.892 [95% confidence interval (CI), 0.813-0.946] in the training set and 0.885 (95% CI, 0.748-0.962) in the validation set. The calibration curve demonstrated that its predicted probabilities were in acceptable agreement with the actual probability. The decision curve analysis illustrated that the current nomogram would add more net benefit.
CONCLUSION
The nomogram integrating the SUV and the CT features could non-invasively predict VPI status before surgery in subpleural clinical stage IA lung adenocarcinoma patients.
Topics: Humans; Fluorodeoxyglucose F18; Pleura; Lung Neoplasms; Adenocarcinoma; Neoplasm Invasiveness; Adenocarcinoma of Lung; Positron Emission Tomography Computed Tomography; Tomography, X-Ray Computed; Multivariate Analysis; Retrospective Studies; Neoplasm Staging
PubMed: 36988049
DOI: 10.4274/dir.2023.222006 -
The Journal of International Medical... Apr 2020A 70-year-old man presented to our hospital because of a cough with bright red blood for 1 month. A chest computed tomography (CT) scan showed that there was a patchy,... (Review)
Review
A 70-year-old man presented to our hospital because of a cough with bright red blood for 1 month. A chest computed tomography (CT) scan showed that there was a patchy, dense shadow below the pleura of the upper lobe of the left lung. This shadow was approximately 2.7 × 2.2 cm in size, with rough edges, adjacent pleural traction, and localized thickening. Percutaneous pulmonary needle biopsy was performed under CT guidance. Morphological features were characterized by multifocal centrilobular distribution of fibromyxoid polyps of granulation tissue in the lumen of distal airspaces and small bronchioles. These findings supported the diagnosis of focal cryptogenic organizing pneumonia. The patient was then treated with ceftazidime and prednisone. After this treatment, the patient visited the clinic and complete resolution of his respiratory symptoms and nearly complete resolution of the mass on chest CT were observed. The findings in our case provide clinical experience to help with the diagnosis of cryptogenic organizing pneumonia, which is difficult to diagnose.
Topics: Aged; Aged, 80 and over; Biopsy; Cryptogenic Organizing Pneumonia; Female; Humans; Lung; Male; Middle Aged; Pleura; Tomography, X-Ray Computed
PubMed: 32321352
DOI: 10.1177/0300060520920068