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PubMed1992

[Clinical study of bioabsorbable PGA sheets for suture reinforcement and use as artificial pleura].

Bioabsorbable PGA non-woven fabric sheets were used to treat 103 patients who underwent pulmonary surgery in three hospitals, and their handleability, applicability, drainage time after surgery and subsequent side effects were studied. For suture reinforcement, these sheets showed satisfactory handleability, applicability and effectiveness for hemostasis and prevention of air leakage at the suture sites. Since this material has good compatibility with fibrin glue, use of these two materials in combination reduced both the operation time and postoperative drainage period. For small fistula and pleural defects, attachment of the sheets with fibrin glue to create an artificial pleura was sufficient for prevention air leakage without suturing. No side effects or complications were observed, and the postoperative courses of all 103 patients were uneventful. These findings suggest that PGA sheets are acceptable for suture reinforcement in the pulmonary surgery, and that when used with fibrin glue, can simplify surgery for emphysematous lung disease and shorten the period of postoperative air leakage.

Absorption↗
PubMed1992

[Mesothelioma of the pleura--pathological anatomy].

The examination of the pathology of diffuse malignant mesotheliomas (DMM) is based upon the analysis of 600 pleural tumours of the German Mesothelioma Panel in Bochum. Macroscopically there is a characteristic feature of the tumour growth, often restricted to the pleura, with preference of the basal pleural parts even in advanced stages. The highly variable growth pattern of the tumour phenotype contains parts of epithelial cells (42%), sarcoma-like cells (18%), and biphasic patterns (27%) as revealed by microscopy. Secondary pleural carcinosis are much more frequent (10 x) as diffuse malignant mesotheliomas but may mimic the DMM. Since there is no specific tumour marker for DMM available, additional immunohistochemical staining using different monoclonal antibodies directed against cytokeratins and epithelial antigens are recommended especially for examinations of small biopsies. The morphological security cheque follows the criteria of the European Mesothelioma Panel and is subdivided into 5 groups: A, assured mesothelioma; B, possible mesothelioma; C, probable mesothelioma; D, possibly no mesothelioma; E, certainly no mesothelioma. In the Bochum panel the incidence of A and B is 66%, of C, 6% and of D and E, 28%. In addition to the histomorphological examinations, in dust analysis of nontumourous lung tissue an augmented asbestos charge has been found in approximately 90% of all cases. The significance of asbestos fibers as an essential cause of the pleural mesothelioma could be underlined by our own animal experiments. After instillation of asbestos fibers into the right lung, a transpleural transport of fibers was observed with preneoplastic lesions and transformation of multipotent subserosal cells.

Asbestosis↗
PubMedDate not supplied

[Malignant mesothelioma of the pleura among women].

BACKGROUND: The epidemiological features of mesothelioma among women differ from those observed among men. OBJECTIVES: To trace the outline of pleural mesothelioma among women in the Monfalcone area, Italy. METHODS: Thirty-three malignant mesotheliomas of the pleura observed in female patients at the Hospital of Monfalcone, Italy, in the period 1979-2002 were reviewed. The diagnosis was based on/or confirmed by necropsy findings in 30 cases. Occupational and social histories were obtained from the patients themselves or from their relatives by personal or telephone interviews. In 29 necropsy cases thoracic cavities were examined for the presence of pleural plaques. Routine lung section were examined for asbestos bodies in 30 cases. In 21 cases asbestos bodies were isolated and counted after chemical digestion of lung tissue. RESULTS: The age of the patients ranged between 48 and 89 years (mean 72.85, median 73.00). All the patients had histories of exposure to asbestos, single in 25 cases and mixed in 8. Exposure at home due to cleaning of work clothes was the most frequent type of exposure. Various patients had been exposed in non-asbestos text industries (cotton mills). Unusual types of exposure occurred in some cases (distillery, small sodium carbonate factory, starch factory). The latency periods (time intervals elapsed between first exposure to asbestos and diagnosis of the tumour), calculated in 23 cases, ranged from 34 to 62 years. Pleural plaques were found in 21 cases. Twelve patients showed asbestos bodies on routine lung sections. The asbestos body burden ranged between only a few bodies and 92,000/g dried tissue. CONCLUSIONS: In contrast with other series of mesothelioma among women, all the present cases were attributable to asbestos. The detection of objective signs of exposure (pleural plaques, lung asbestos bodies) played a key role in attribution.

Age Factors↗
PubMed2004

[Malignant mesothelioma of the pleura--diagnostic difficulties].

Malignant mesothelioma of the pleura is a rare neoplasm with a poor prognosis. Noncharacteristic clinical signs, radiological features and similarity to other neoplasma (adenocarcinoma) in a microscopical evaluation lead to often diagnostic problems. Thoracoscopy followed by biopsy is routinely performed and is considered a main diagnostic procedure. Microscopic samples are usually examined by immunohistochemical analysis. In this report, presented is a case of malignant pleural mesothelioma, in which final diagnosis was delayed because of difficulties in diagnosis based on thoracoscopic biopsy.

Biopsy↗
PubMed2006

Serosal membranes (pleura, pericardium, peritoneum). Normal structure, development and experimental pathology.

This monograph offers a comprehensive review of the present knowledge of the structure of the serosal coverings of the pleural, pericardial, and peritoneal cavities in humans and laboratory animals. The authors provide data from their own research--with transmission and scanning electron microscopy--on the structure of the main components of the serosal membranes: mesothelial cells, underlying basal lamina, and submesothelial connective tissue layer. Two main types of mesothelial cells (flat and cubic) are distinguished and their distribution on the parietal serosal sheets and on the visceral coverings of various organs is described. The openings between mesothelial cells (stomata) and their relations with lymphatic lacunae are described thoroughly. Special reference is made to the serosal accumulations of lymphoid tissue (milky spots). The transcellular and intercellular transport to and from serosal cavities is studied by means of horseradish peroxidase tracing experiments. The prenatal and postnatal developmental studies are focused on human and rat pleura. The alterations of serosal membranes after experimental hemothorax, pneumonectomy, and peritonitis caused by Pseudomonas aeruginosa application suggest the existence of early, reversible, and late, definite periods.

Animals↗
PubMed1991

[Morphological changes in the pleura caused by intracavitary administration of bleomycin].

We administered bleomycin to the intrapleural cavity of hamsters and observed acute and chronic histological changes of visceral pleura using light and electron microscopies. At 7 days after bleomycin challenge, we could find out the pleural thickening with infiltration of inflammatory cells, and then formation of pleural fibrosis at 28 days. However, in our study there was no abnormal findings of the lung parenchyma in morphology and intraalveolar cells, and lung distensibility. The dose (10-20 units/kg body weight) used in the study did not cause the abnormal changes in the parenchyma, although pleural thickening occurred. We suggest that intracavitary bleomycin administration is safely used for the treatment of malignant pleural effusion.

Animals↗
PubMed1991

[Changes in the pleura of subjects occupationally-exposed to asbestos: radiological study technique, spectrum, etiological classification and coding according to the ILO classification].

Pleural abnormalities of 119 occupationally asbestos-exposed with prominent internal stripe of the lateral thoracic wall were radiodiagnostically analysed by plain films of the thorax in four views and by computed tomography in the course of medical expert's certification. Abnormalities were coded according to 1980 ILO international classification of pneumoconioses. Hardly half of the patients had pleural abnormalities caused by asbestos exposure: Pleural plaques, "diffuse" pleural fibrosis, pleural effusions, organized pleural effusions and pleural tumors. The other half of the patients had pleural involvement of pulmonary and chest wall abnormalities or variations of the lateral thoracic wall not related to asbestos exposure. The 1980 ILO classification of pneumoconioses proved to be inadequate for complete coding of the abnormalities, since only the postero-anterior plain film of the thorax must be used, since the normal appearance of the pleura is insufficiently defined and since the entity of organized pleural effusion is lacking.

Asbestosis↗
PubMed1990

[Foreign bodies in the lungs and pleura after intrathoracic surgical interventions (clinico-anatomical parallels)].

Clinicoanatomical analysis of 6 cases of pathological processes in the lungs and pleura caused by gauze cloths left carelessly during operative treatment of pulmonary diseases was carried out. It was found that the character of these accidentally induced sufferings depended on the volume of the surgical intervention and the time during which the foreign bodies remained in the pleural cavity or the operative wound. The complications caused by the presence of gauze cloths accidentally left in the pleural cavity or lung follow a course separately from the initial pulmonary pathological process, have no pathogenetic relations to it, and possess a characteristic clinicoanatomical picture which allows them to be evaluated as surgical iatrogenesis, an equivalent of a nosological unit.

Adolescent↗
PubMed1990

Effects of tetracycline hydrochloride on pleurae in dogs with induced pleural effusion.

Pleural effusion was induced in 12 dogs by ligation of the cranial vena cava. Pleurodesis was attempted by injecting a solution of tetracycline hydrochloride into the pleural space of 8 dogs (4 dogs, 25 mg/kg of body weight; 4 dogs, 50 mg/kg) via bilateral thoracostomy tubes. In both groups, tetracycline was diluted in 40 ml of normal saline solution and 10 ml of 1% lidocaine before injection. Half of the solution (25 ml) was instilled in each hemithorax. Four control dogs were treated in the same manner with a solution of normal saline and lidocaine. Daily pleural fluid production was measured after the attempted pleurodesis. Thirty days after administration of the solution, each dog was euthanatized and necropsied. Surface area of pleural adhesions was measured. Tissues from regions of pleural adhesions and areas of parietal and visceral pleura not involved in adhesions were analyzed histologically. Formation of pleural fluid stopped in all but 1 control dog within 48 hours after injection of solution. This dog effused throughout the study. The resolution of effusion was not significantly (P less than 0.05) different between the tetracycline-treated dogs and the control group. Although diffuse pleural adhesions were not induced in any of the dogs, significantly (P less than 0.0027) more surface area of lung was adhered in dogs treated with the higher dose of tetracycline.

Animals↗
PubMed1990

[Needle biopsy of the pleura and medical alternatives in pleurisy of unknown etiology].

The presentation contains diagnosis verification findings concerning 328 patients with pleurisy of different etiology. At the first stage of the examination (without pleura biopsy), the pleurisy etiology was defined in 100 (30.5%) patients, including 55 with tumoral, 24 with tuberculous, 19 with cardiac and 2 with allergic pleurisy. Puncture biopsy was conducted in 200 patients aged from 17 to 83 years. The use of biopsy made it possible to determine the pleurisy nature in 72 (45%) out of 160 cases with an exudative one and in 23 (57.5%) out of 40 cases with a fibrinous one. The effectiveness of a single biopsy accounted for 41% while a repeated one could increase the information potential by 6.5%. The information potential in case of tuberculous and tumoral pleurisy ammounted to 75 and 70%, respectively.

Adolescent↗
PubMed1990

[The pathomorphological changes in the pleura of rabbits with artificial pneumothorax and uropolin pleurography].

The results from artificial pneumothorax in 25 rabbits with intrapleural administration of Uropolin (10 rabbits) as well as of 10% solution of NACl (7 rabbits) were described. Thoracotomy was made on 7th, 14th and 12 21st day and the parietal, diaphragmatic and visceral pleura with underlaying tissues were examined. Proliferation of the mesothelium [correction of mesother] and growth of the connective tissue, which were more manifested in rabbits treated with Uropolin, were established histologically. The authors think that pathohistological examinations confirm the clinical observed favourable effect of intrapleural administration of Uropolin for obliteration of the pleural cavity.

Animals↗
PubMed1989

Mesothelial papillary proliferation of the pleura associated with radiation therapy: does it have a role in the pathogenesis of mesothelioma?

Diffuse papillary proliferation of mesothelial cells in the pleura mimicking metastatic carcinoma was seen four weeks following radiation therapy for a Pancoast tumor. Such papillary proliferations are not observed incidentally and are envisioned to occur during asbestos-induced carcinogenesis. We postulate that similar papillary lesions may serve as a link in the pathogenesis of radiation-induced mesotheliomas.

Aged↗
PubMed1989

Pharmacokinetics of cefonicid in serum and its penetration into lung tissue, bronchial mucosa and pleura.

Cefonicid pharmacokinetics in serum and tissue penetration into the lung parenchyma, bronchial mucosa and pleura were studied in 39 patients undergoing lung excision for malignancy. Cefonicid concentrations in serum and tissues samples were assayed at different times after a single 1 g intramuscular administration. The concentrations observed were much higher than the reported minimal inhibitory concentrations for the microorganisms commonly responsible for bronchial and pulmonary infections and therapeutic concentrations were still detectable in the tissues 24 h after dosing. Kinetic findings demonstrated a similar half-life for cefonicid in tissues and in serum. These data provided a further kinetic explanation for the observed clinical efficacy of cefonicid with a single daily dose.

Adult↗
PubMed1989

[Soft tissue tumors of the lung and pleura].

We present two patients with lung and pleura soft tissue tumours. A 37 year-old man had a small, highly malignant tumour which had invaded the mitral valve. The presenting symptom was mitral stenosis. The tumour was classified as a leiomyosarcoma. A 65 year-old female had a large tumour, which was most probably a solitary fibrous mesothelioma. Hypoglycaemia was evident. Insulin-like growth factor I was produced by tumour cells, although the hormone was not found in the plasma.

Adult↗
PubMed1986

Primary malignant fibrous histiocytoma of the pleura. A case report.

An uncommon primary malignant fibrous histiocytoma (MFH) of the pleura is described. At light microscopy the tumor was characterized by a 'storiform' pattern of growth, with numerous multinucleated giant cells. Immunohistochemistry showed an intense, diffuse immunostaining for alpha-1-antitrypsin, focal for lysozyme. Ultrastructurally, histiocyte- and fibroblast-like cells and cells with intermediate features were present; moreover, it was possible to demonstrate the presence of mesenchymal 'stem' cells. Findings are discussed, also with respect to histogenesis of MFH.

Female↗
PubMed1988

[Use of urea in the treatment of patients with suppurative diseases of the lungs and pleura].

Under analysis were results of treatment of 96 patients with suppurative diseases of the lungs and pleura. The 30% solution of urea was locally used in 59 patients as pleural punctures, introduction of the solution through drains into the purulent cavity by dropping irrigation of bronchi and tamponage of open purulent cavities. Gram-positive microorganisms were found to die in the 30% solution of urea within 30 min.--3 h, gram-negative ones--within 30 min.--1 h. The introduction of urea directly into the purulent infection focus against the background of general therapy allowed to quickly block the acute phase of the suppurative process, to prepare the patients to planned operations and to reduce the amount of postoperative complications as compared with a control group of patients who were treated by routine local antiseptic drugs.

Adolescent↗
PubMed1988

[Structural characteristics of the mediastinal pleura and its blood vessels].

By means of impregnation of the microcirculatory bed vessels after V. V. Kupriyanov and transmissive electron microscopy, topological picture of hemomicrovessels has been estimated in the glomerular constructions of the dog mediastinal pleura. The composition of cell elements and peculiarities in distribution of the latter in the zone of the milk spots are examined. Their structural characteristics are manifested as presence of mesothelium of a decomplexated type accumulation of macrophagal and lymphocyto-plasma cells, glomerular organization of the capillary network and postcapillary venules, two types of endothelial lining of the metabolic microvessels. The role of the milk spots in ensuring immune protection, in migration of macrophages and in filtration of the pleural liquid is discussed.

Animals↗
PubMed1986

Benign and malignant mesothelial lesions of the pleura: quantitative study.

Benign and malignant mesothelial lesions of the pleura are quantitatively studied using a Leitz TAS image analyzing system. The Feulgen fast green staining method allows performing on the same cell measurements of the shape and size of the nucleus, the size of the nucleolus and the content of DNA. Numerical data are studied in a multivariate statistical analysis in order to obtain the probability of the morphometric diagnosis in each case. Results demonstrate that the most important measurements are the percentage of cells with evident nucleolus, the nuclear perimeter and the standard deviation of the DNA content, and that these measurements give a correct diagnosis in all cases.

Analysis of Variance↗