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PubMed1981

Determination of pulmonary deposition, translocation and clearance using neutron activation techniques.

Neutron activation provides a sensitive technique to estimate pulmonary deposition, translocation and clearance of inhaled particles. Talc and fly ash were irradiated in an integrated neutron flux of or approximately 10(16) n/cm2. Radionuclides were induced by (n, gamma) reactions on major an minor elements in the dusts. Hamsters received a single nose-only exposure to the dusts. Groups of 4 to 6 animals were than serially sacrificed at intervals up to 4 months postexposure. Lungs, other tissues of interest and excreta were collected for gamma-ray analysis. Limit of detection for the isotopes 60Co or 46Sc was or approximately 0.1 dpm, facilitating detection of 10(-11) gram quantities of these elements. Analyzing for more than one radionuclide and comparing their ratios in the bulk dust to those in the tissue or excreta indicated whether a radionuclide leached from the particle or represented particles in the tissue samples. Six to 8% of the inhaled talc were deposited in the alveoli; its biological half-life in the lung was 7 to 10 days. Alveolar clearance was essentially complete 4 months postexposure. No translocation of talc to liver, kidneys, ovaries of other parts of the body was found. Picogram quantities of 60Co found in the urine probably represented leached 60Co, absorbed in the gastrointestinal tract. Two to 3% of the inhaled fly ash were initially retained in the respiratory tract. Estimated biological half-lives were 3 and 35 days for airways and alveoli, respectively. After 99 days the mean lung burden had decreased to about 10% of its initial value; extrapolation suggests near-complete pulmonary clearance at about 200 days postexposure.

Activation Analysis↗
PubMed1994

Occupation and ovarian cancer: a case-control study in the Washington, DC, metropolitan area, 1978-1981.

Ovarian cancer risk factors may be genetic, reproductive, or hormonal in nature. Occupational exposure to talc and other carcinogenic substances has not been studied in relation to ovarian cancer risk. We therefore examined the job histories of 296 women aged 20 to 79 who were diagnosed with epithelial ovarian cancer in the Washington, DC area in 1978 to 1981, comparing them to 343 hospital controls, matched for age and race. A blind exposure assessment, evaluating each job/industry combination for potential exposure to talc, ionizing radiation, polycyclic aromatic hydrocarbons, and solvents was conducted by an industrial hygienist blind to case-control status. Women exposed to talc had a relative risk of ovarian cancer below the null, but the confidence interval was wide and there was no evidence of a trend. Women exposed to polycyclic aromatic hydrocarbons had an elevated relative risk, also with a wide confidence interval and no evidence of a trend with duration.

Adult↗
PubMedDate not supplied

Thoracoscopic management of malignant pleural effusion.

The results of thoracoscopic biopsy and talc pleurodesis in the management of malignant pleural effusions, is analysed. The study population consisted of 213 patients. Pre-operative cytology was positive in only 27% of patients; the diagnostic yield using thoracoscopic biopsy was 91.5%. (Sensitivity 99%; specificity 100%; positive predicted value 100%; negative predicted value 88%). Talc pleurodesis at thoracoscopy produced symptomatic improvement in 93% of patients. Post-operative complications occurred in 3.7% and there was a 2.3% mortality. Recurrent effusion was not a significant clinical problem. Thoracoscopy enhances the accuracy of diagnosis of pleural effusions; simultaneous talc pleurodesis has a high therapeutic success.

Adult↗
PubMed1994

[Chemical pleurodesis with iodized talcum in persistent therapy refractory bronchocutaneous fistula].

The common therapy of a persistent bronchocutaneous fistula is the operative endoscopic repair of the leak, the parietal pleurectomy or the endoscopic pleurodesis with different agents. Therefore the thoracotomy with all the risks for the patient can be avoid. Complications seen in the thoracoscopic treatment are low and often the result of techniqual problems. However there must be an alternative therapy for patients with a high operational risk. In our case we treated a bronchocutaneous persistent fistula by the instillation of iodized talc effectively. Although talc and others agents are used in the therapy of malignant pleural effusions, the talc poudrage in the therapy of bronchocutaneous fistulas is a good alternative treatment for patients in a bad condition.

Bronchial Fistula↗
PubMed1993

Prevention of seroma formation after dissection of musculocutaneous flaps.

Dissection of musculocutaneous flaps is uniformly followed by the formation of seroma if drains are not used. Drains can be colonized and form deep tissue infection if left in place for a long time. In this study we investigated whether talc poudrage could prevent the formation of seroma following dissection of the latissimus dorsi muscle in a canine model. Twelve mongrel dogs were randomized into two groups. Group 1 (n = 6) underwent dissection of the left latissimus dorsi muscle which was rotated as a pedicle flap into the left chest through a second intercostal space thoracotomy. The wound was closed in layers without drains. Group 2 (n = 6) had the same procedure, but before closure of the wound, USP talc was applied to the tissues. All animals received cefazolin (500 mg) Q8h for 48 hours perioperatively. Animals were followed for 1-5 months. Wounds with fluctuation were aspirated as many times as necessary and the amount of fluid was recorded. All Group 1 animals developed seromas, in contrast, only one animal in group 2 had a seroma. There was a significant difference in the amount of fluid aspirated for each animal between the two groups (280 +/- 80 in group 1 vs 25 +/- 25 ml in group 2, P < 0.05). The total amount of fluid drained in group 1 was 1730 ml, whereas only 150 ml was aspirated in group 2. Group 1 animals required a total of 11 aspirations to control seromas, in contrast, only one aspiration was needed in group 2. No abscess was identified at postmortem in either group. Based on the results of this study we conclude that talc poudrage can be safely used to minimize seroma formation after dissection of musculocutaneous flaps.

Animals↗
PubMed1980

In vitro adsorption studies of cimetidine.

The adsorption of cimetidine on selected pharmaceuticals including kaolin, activated charcoal, talc, and nonsystemic antacids was determined at pH 5.0 and 25 degrees. The Langmuir and Freundlich adsorption isotherms showed that cimetidine adsorption was significant with activated charcoal, kaolin, talc, and magnesium trisilicate and was virtually nonexistent with magnesium hydroxide and aluminum hydroxide. Equations expressing the Freundlich and Langmuir adsorption isotherms were evaluated for each adsorbent. The approximate amounts of cimetidine adsorbed per gram of adsorbent were 25.6, 0.402, 0.291, and 0.343 mg for charcoal, kaolin, talc, and magnesium trisilicate, respectively. These in vitro studies indicate that some cimetidine may be lost when it is administered concomitantly with pharmaceutical adsorbents.

Adsorption↗
PubMed2005

Therapeutic options for refractory massive pleural effusion in systemic lupus erythematosus: a case study and review of the literature.

OBJECTIVES: Massive refractory pleural effusions are uncommon in patients with systemic lupus erythematosus. Describing such a patient, the literature was reviewed to report the various therapeutic options in such cases. METHODS: MEDLINE search using the terms "lupus" and "pleural effusion," inclusion of cases with refractory massive effusions with emphasis on treatment. RESULTS: Only 10 such cases (including the patient described here) were reported in the English literature over the past 25 years. Those 10 patients suffered symptoms related to pleural effusion for a long period of time until resolution, ranging between 2 months to 2.5 years (median 6 months). During that period of time they underwent multiple fluid aspirations. Seven different types of therapy were reported in these case descriptions. They can be divided into 2 major groups: systemic therapy (immunosuppressive therapy, plasmapheresis, and intravenous immunoglobulin) and local therapy (intrapleural steroid injections, pleurodesis with talc or tetracycline, and pleurectomy). Pleurodesis with talc seemed to be the most effective treatment modality. CONCLUSIONS: Due to the small number of reported patients, the best type of intervention is uncertain. When refractory pleural effusion is part of lupus exacerbation, the treatment of choice would be systemic, such as immunosuppressive therapy with high-dose steroids and cyclophosphamide. Intravenous immunoglobulin may also be considered. Local measures such as talc pleurodesis should be employed if systemic measures fail, or when pleural effusion is the only manifestation of lupus.

Adult↗
PubMed1999

Tackiness of acrylic and cellulosic polymer films used in the coating of solid dosage forms.

The objective was to determine the tackiness of acrylic and cellulosic polymer films in order to make predictions on the tackiness (agglomeration) of coated dosage forms during coating and curing. Force-displacement curves of the detachment process of two polymeric films were used as a measure of tackiness. Various polymers (cellulosic (Aquacoat and acrylics (Eudragit RS 30D, L 30D, NE 30D)), plasticizers (triacetin, triethyl citrate, tributyl citrate, acetyltributyl citrate) and anti-tacking agents (talc and glyceryl monostearate) were investigated. The order of tackiness for films prepared from the different aqueous polymer dispersions was in order of Eudragit NE 30D > RS 30D > RL 30D > Aquacoat. The tackiness increased with increasing plasticizer concentration due to the softening of the polymer. A correlation between the minimum film formation temperature and the tackiness was observed, however, no correlation between the tackiness and the lipophilicity of the plasticizer was seen. Talc and glyceryl monostearate (GMS) reduced the tackiness of the films significantly, with GMS being effective at much lower concentrations. Curing of Eudragit RS 30D-coated theophylline beads at temperatures higher than 40 degrees C in an irreversible agglomeration of the beads and damage of the coating upon separation of the beads. This resulted in a faster release than with uncured beads. Blending the beads with talc just prior to the curing step eliminated the agglomeration and therefore film damage, even at a curing temperature of 60 degrees C.

Acrylates↗
PubMed2006

Wetting and spreading of a surfactant film on solid particles: influence of sharp edges and surface irregularities.

In addition to particle size and surface chemistry, the shape of particles plays an important role in their wetting and displacement by the surfactant film in the lung. The role of particle shape was the subject of our investigations using a model system consisting of a modified Langmuir-Wilhelmy surface balance. We measured the influence of sharp edges (lines) and other highly curved surfaces, including sharp corners or spikes, of different particles on the spreading of a dipalmitoylphosphatidyl (DPPC) film. The edges of cylindrical sapphire plates (circular curved edges, 1.65 mm radius) were wetted at a surface tension of 10.7 mJ/m2 (standard error (SE) = 0.45, n = 20) compared with that of 13.8 mJ/m2 (SE = 0.20, n = 20) for cubic sapphire plates (straight linear edges, edge length 3 mm) (p < 0.05). The top surfaces of the sapphire plates (cubic and cylindrical) were wetted at 8.4 mJ/m2 (SE = 0.54, n = 20) and 9.1 mJ/m2 (SE = 0.50, n = 20), respectively, but the difference was not significant (p > 0.05). The surfaces of the plates showed significantly higher resistance to spreading compared to that of the edges, as substantially lower surface tensions were required to initiate wetting (p < 0.05). Similar results were found for talc particles, were the edges of macro- and microcrystalline particles were wetted at 7.2 mJ/m2 (SE = 0.52, n = 20) and 8.2 mJ/m2 (SE = 0.30, n = 20) (p > 0.05), respectively, whereas the surfaces were wetted at 3.8 mJ/m2 (SE = 0.89, n = 20) and 5.8 mJ/m2 (SE = 0.52, n = 20) (p < 0.05), respectively. Further experiments with pollen of malvaceae and maize (spiky and fine knobbly surfaces) were wetted at 10.0 mJ/m2 (SE = 0.52, n = 10) and 22.75 mJ/m2 (SE = 0.81, n = 10), respectively (p < 0.05). These results show that resistance to spreading of a DPPC film on various surfaces is dependent on the extent these surfaces are curved. This is seen with cubic sapphire plates which have at their corners a radius of curvature of about 0.75 microm, spiky malvaceae pollen with an even smaller radius on top of their spikes, or talc with various highly curved surfaces. These highly curved surfaces resisted wetting by the DPPC film to a higher degree than more moderately curved surfaces such as those of cylindrical sapphire plates, maize pollens, or polystyrene spheres, which have a surface free energy similar to that of talc but a smooth surface. The macroscopic plane surfaces of the particles demonstrated the greatest resistance to spreading. This was explained by the extremely fine grooves in the nanometer range, as revealed by electron microscopy. In summary, to understand the effects of airborne particles retained on the surfaces of the respiratory tract, and ultimately their pathological potential, not only the particle size and surface chemistry but also the particle shape should be taken in consideration.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed2004

Microencapsulation of a hydrophilic drug into a hydrophobic matrix using a salting-out procedure. II. Effects of adsorbents on microsphere properties.

Wax microspheres of the hydrophilic drug guaifenesin were prepared by the congealable disperse-phase method using a salting-out procedure. In order to improve the particle properties of the microspheres, adsorbents (colloidal silica, magnesium stearate, and talc) were used during preparation. The effects of adsorbents on microsphere properties such as the angle of repose (AR), compressibility index (CI), geometric mean diameter (GMD), loading efficiency (LE), and in vitro drug release (DR) were determined. The AR, CI, and GMD of the microspheres were significantly reduced in the presence of the adsorbents. Increase in the concentrations of colloidal silica and magnesium stearate led to lower LE and faster DR, while talc showed no effect, which could be due to the particle diameter and specific surface area of the adsorbents. The microspheres prepared with colloidal silica were chosen to be compressed into tablets since they were smaller, more uniform, and had better flow properties than those made with magnesium stearate and talc. The in vitro drug release profile of the microsphere tablets was compared with that of commercially available Mucinex, sustained release guaifenesin matrix tablets. Similar release profiles were observed between the two tablets. Scanning electronic microscopy (SEM) studies of the broken tablets revealed that the deformation of the microspheres caused by compression was minimal.

Adsorption↗
PubMed1995

Thoracoscopic management of pleural effusions revisited.

Pleural effusion is a commonly encountered clinical condition. We report our experience with video assisted thoracoscopic surgery (VATS) in the management of pleural effusions in three groups of patients: (1) Patients with cryptogenic pleural effusions for diagnosis; (2) patients with established malignant effusions for talc insufflation and limited decortication; and (3) patients with early empyema for debridement and drainage. From September 1992 to March 1994, we have successfully managed 28 patients with pleural effusions (12 males, 16 females; age ranged from 22 days to 73 years). Management consisted of 16 diagnostic thoracoscopies with guided pleural biopsies, seven limited decortications for trapped lungs, 12 talc insufflation for recurrent symptomatic malignant effusions and debridement and drainage of five empyemata. There was no mortality or intra-operative complications. The procedure was tolerated well by all patients. The mean duration of chest drainage and hospital stay were 1.2 and 2.8 days for group 1 patients, 4.5 and 6.4 days for group 2, and 5.6 and 7.1 days for group 3. Specific histological diagnosis was obtained in all but two patients (88%). Thoracoscopic talc insufflation was successful in 92% of cases at mean follow up of 8 months. Thoracoscopic debridement and drainage of empyema resulted in rapid resolution of sepsis in all cases. Advances in video camera technology and instrumentation have allowed more therapeutic manoeuvres to be carried out. We conclude that VATS is a safe and effective way of managing selected patients with pleural effusions.

Adult↗
PubMed1998

Effect of inoculation techniques and relative humidity on the growth of molds on the surfaces of yellow layer cakes.

FOUR INOCULATION TECHNIQUES WERE COMPARED FOR INITIATION OF GROWTH ON CAKE SURFACES: spot, air cabinet, spray (atomizer), and talc addition methods. Molds were isolated from commercial cakes and were identified as Aspergillus sydowii, Aspergillus ochraceus, Penicillium funiculosum, and Eurotium herbariorum. Cake surfaces were inoculated with mold spores and incubated under three equilibrium relative humidity (ERH) levels: 97, 85, and 75%. Random contamination by spores in a ventilated air cabinet was the simplest method of inoculation, but standard deviations in the inoculation rates (20% on a relative scale) were almost twice those observed with the other methods. The spot method was the most reproducible. Cake samples inoculated in the air cabinet had colony counts 10 times lower than those obtained for potato dextrose agar plates at 97% ERH, which was not the case with the spray and talc methods. Growth of molds was much slower in the samples incubated in 75% relative humidity, with all methods. Colony counts were generally similar in systems adjusted at 85 to 97% ERH but were lower for samples incubated at 75% ERH. In comparisons of the shelf life estimates obtained by the various inoculation methods, a correlation coefficient (r) of 0.70 was obtained between the spot method and the other methods of inoculation, while talc, air cabinet, and spray shelf life data were correlated better (r approximately 0.97). The spot method appeared to be the method of choice in consideration of ease of use, precision, and the ability to enable the study of the effects of the environment on mold-free shelf life as well as on the rate of growth of molds on cakes.

Journal Article↗
PubMed1993

A case-control study of malignant and non-malignant respiratory disease among employees of a fiberglass manufacturing facility. II. Exposure assessment.

A case-control study of malignant and non-malignant respiratory disease among employees of the Owens-Corning Fiberglas Corporation's Newark, Ohio plant was undertaken. The aim was to determine the extent to which exposures to substances in the Newark plant environment, to non-workplace factors, or to a combination may play a part in the risk of mortality from respiratory disease among workers in this plant. A historical environmental reconstruction of the plant was undertaken to characterise the exposure profile for workers in this plant from its beginnings in 1934 to the end of 1987. The exposure profile provided estimates of cumulative exposure to respirable fibres, fine fibres, asbestos, talc, formaldehyde, silica, and asphalt fumes. Employment histories from Owens-Corning Fiberglas provided information on employment characteristics (duration of employment, year of hire, age at first hire) and an interview survey obtained information on demographic characteristics (birthdate, race, education, marital state, parent's ethnic background, and place of birth), lifetime residence, occupational and smoking histories, hobbies, and personal and family medical history. Matched, unadjusted odds ratios (ORs) were used to assess the association between lung cancer or non-malignant respiratory disease and the cumulative exposure history, demographic characteristics, and employment variables. Only the smoking variables and employment characteristics (year of hire and age at first hire) were statistically significant for lung cancer. For non-malignant respiratory disease, only the smoking variables were statistically significant in the univariate analysis. Of the variables entered into a conditional logistic regression model for lung cancer, only smoking (smoked for six months or more v never smoked: OR = 26.17, 95% confidence interval (95% CI) 3.316-206.5) and age at first hire (35 and over v less than 35: OR = 0.244, 95% CI 0.083-0.717) were statistically significant. There were, however, increased ORs for year of employment (first hired before 1945 v first hire after 1945: OR = 1.944, 95% CI 0.850-4.445), talc (cumulative exposure >1000 fibres/ml days v never exposed: OR = 1.355, 95% CI 0.407-5.515), and asphalt fumes (cumulative exposure >0.01 mg/m(3) days v never exposed: OR 1.131, 95% CI 0.468-2.730). For non-malignant respiratory disease, only the smoking variable was significant in the conditional logistic regression analysis (OR = 2.637, 95% CI 1.146-6.069). There were raised ORs for the higher cumulative exposure categories for respirable fibres, asbestos, silica, and asphalt fumes. For both silica and asphalt fumes, ORs were more than double the reference groups for all exposure categories. A limited number of subjects were exposed to fine fibres. The scarcity of cases and controls limits the extent to which analyses for fine fibre may be carried out. Within those limitations, among those who had worked with fine fibre, the unadjusted, unmatched OR for lung cancer was (1.0 (95% CI 0.229-4.373) and for non-malignant respiratory disease, the OR was 1.5 (95% CI 0.336-6.702). The unadjusted OR for lung cancer for exposure to fine fibre was consistent with that for all respirable fibre and does not suggest an association. For non-malignant respiratory disease, the unadjusted OR for fine fibre was opposite in direction from that for all respirable fibres. Within the limitations of the available data on fibre, there is o suggestion that exposure to fine fibre has resulted in an increase in risk of lung cancer. The increased OR for non-malignant respiratory disease is inconclusive. The results of this population, in this place and time, neither respirable fibres nor any of the substances investigated as part of the plant environment are statistically significant factors for lung cancer risk although there are increased ORs for exposure to talc and asphalt fumes. Smoking is the most important factors in risk for lung cancer in this population. The situation is less clear for non-malignant respiratory disease. Unlike lung cancer, non-malignant respiratory represents a constellation of outcomes and not a single well defined end point. Although smoking was the only statistically significant factor for non-malignant respiratory disease in this analysis, the ORs for respirable fibres, asbestos, silica, and asphalt fumes were greater than unity for the highest exposure categories. Although the raised ORs for these substances may represent the results of a random process, they may be suggestive of an increased risk and require further investigation.

Adult↗
PubMed2006

Management of spontaneous pneumothorax: state of the art.

Spontaneous pneumothorax remains a significant health problem. However, with time, there have been improvements in pathogenesis, diagnostic procedures and both medical and surgical approaches to treatment. Owing to better imaging techniques, it is now clear that there is almost no normal visceral pleura in the case of spontaneous pneumothorax, and that blebs and bullae are not always the cause of pneumothorax. In first episodes of primary spontaneous pneumothorax, observation and simple aspiration are established first-line therapies, as proven by randomised controlled trials. Aspiration should be better promoted in daily medical practice. In the case of recurrent or persistent pneumothorax, simple talc poudrage under thoracoscopy has been shown to be safe, cost-effective and no more painful than a conservative treatment using a chest tube. There are also new experimental data showing that talc poudrage, as used in Europe, does not lead to serious side-effects and is currently the best available pleural sclerosing agent. Alternatively, surgical techniques have considerably improved, and are now less invasive, especially due to the development of video-assisted thoracoscopic surgery. Studies suggest that video-assisted thoracoscopic surgery may be more cost-effective than chest tube drainage in spontaneous pneumothorax requiring chest tube drainage, although it is more expensive than simple thoracoscopy and requires general anaesthesia, double-lumen tube intubation and ventilation. Recommendations are made regarding the treatment of pneumothorax. In secondary or complicated primary pneumothorax, i.e. recurrent or persistent pneumothorax, some diffuse treatment of the visceral pleura should be offered, either by talc poudrage under thoracoscopy or by video-assisted thoracoscopic surgery. Moreover, all of these new techniques should be better standardised to permit comparison in randomised controlled studies.

Cost-Benefit Analysis↗
PubMed1994

Treatment of patients with spontaneous pneumothorax during videothoracoscopy.

Thoracoscopy for spontaneous pneumothorax has been performed over the years by many pulmonologists. The aim of the procedure was merely diagnostic: the detection of blebs and bullae. Therapeutic modalities were restricted to chemical pleurodesis. The development of videothoracoscopy has made more complex interventions, such as bullectomy possible. A protocol for videothoracoscopic treatment of spontaneous pneumothorax, with all treatment modalities in one session, has been developed. All patients with spontaneous pneumothorax underwent videothoracoscopy under general anaesthesia with double lumen tube intubation. If no abnormalities were found on the visceral pleura, talc pleurodesis was performed. Small lesions, blebs or bullae < 2 cm, were coagulated prior to pleurodesis. In case of blebs or bullae > 2 cm, thoracoscopic resection with an EndoGIA stapling device was performed, followed by scarification, i.e. electrocoagulation, of the parietal pleura. In 43 patients, 44 procedures were performed. In 15 cases (34%) no blebs or bullae were found. In 6 cases (14%) only blebs < 2 cm were found. In 23 cases (52%) blebs and bullae > 2 cm were found. In 21 out of 44 cases (48%), talc pleurodesis was performed, and in 23 cases (52%) bullectomy was performed. No major complication occurred. The average hospital stay was 5.7 days after talc pleurodesis and 6.0 days after bullectomy. There were 2 recurrences (5%) after a follow-up of at least 18 months. In conclusion, the use of videothoracoscopy in spontaneous pneumothorax makes it possible to continue a diagnostic procedure as a therapeutic session.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2006

CT of pleural abnormalities in lymphangioleiomyomatosis and comparison of pleural findings after different types of pleurodesis.

OBJECTIVE: The objective of our article was to describe the spectrum and frequency of pleural abnormalities on CT in patients with lymphangioleiomyomatosis (LAM) and the pleural findings associated with different types of pleurodesis (talc, mechanical, and chemical) performed to treat the complications of pleural disease in these patients. MATERIALS AND METHODS: Two hundred fifty-eight patients with LAM underwent CT of the chest. Pleural abnormalities assessed included pleural thickening, presence of a pleural mass, areas of high attenuation, effusion, and pneumothorax. In patients who had had pleurodesis, the CT findings were correlated with the type of procedure performed. RESULTS: One hundred thirty-three (52%) of 258 patients had pleurodesis (unilateral, 68/133; bilateral, 65/133). Pleural abnormalities were more common in patients who had pleurodesis (101/133, 76%) than in those who had not (47/125, 38%) and were more prevalent on the operated side than on the unoperated side of those 68 patients who had unilateral pleurodesis. The frequencies of findings for the group without pleurodesis versus the group with pleurodesis were pleural thickening (26% vs 65%), effusion (10% vs 13%), loculated effusion (2.4% vs 11%), pneumothorax (1.6% vs 10%), areas of high attenuation (1.6% vs 23%), and mass (0.8% vs 14%), respectively. Areas of high attenuation in the pleura were present in all types of pleurodesis (mechanical, 8%; chemical, 13%; talc, 40%) and in two patients who had had repeated thoracentesis or pleurectomy. Pleural masses were present in patients who had had all types of pleurodesis (mechanical, 10%; chemical, 9%; talc, 24%) and in one patient who had had thoracentesis and thoracostomy; the masses commonly enhanced and did not change in size over time. CONCLUSION: Pleural abnormalities are common in patients with LAM as complications of the disease itself and as sequelae of pleurodesis and other pleura manipulations. Pneumothorax and pleural effusion result from the underlying pathophysiology of LAM, whereas areas of high attenuation and masses develop after all types of pleurodesis and other manipulations of the pleura (i.e., thoracentesis, thoracostomy).

Adult↗
PubMed1998

[Treatment strategies in malignant pleural effusion of breast carcinoma].

Symptoms are dyspnea, pain and reduced common feeling. Aine of the study was, to compare our results of talc pleurodesis with the literature. In a prospective trial we performed talc pleurodesis via a chest tube in 41 patients. All patients had radiologically proven pleural effusions. No additional therapy was permitted 30 days before or after entry into the study. Response was assessed monthly. Seven patients dies because of tumor progress. We examined 34 patients. Treatment was successful in 31 patients adverse effects we saw only a few times. Application of iodized talc for therapy of malignant pleural effusions is effective and cheep. We did not see major adverse effects or complications.

Adult↗
PubMed1999

Transpupillary argon laser cyclophotocoagulation in the treatment of traumatic glaucoma.

PURPOSE: A patient with traumatic glaucoma who underwent transpupillary argon laser cyclophotocoagulation for management of uncontrolled intraocular pressure (IOP) despite maximally tolerated medical therapy is discussed. METHODS: In this patient, pars plana vitrectomy, lensectomy, and removal of 180 degrees of necrotic iris had been performed after a blunt trauma with a bungee cord. Six weeks after surgery, the patient presented with an IOP of 40 mmHg despite therapy with three aqueous suppressants. The patient refused further surgical intervention and opted for transpupillary argon laser cyclophotocoagulation (TALC). The laser setting was 1,000 mW, with a 50-micron spot size for 0.1 second. A total of 293 laser exposures through a Goldmann contact lens was administered to all visible ciliary processes over 180 degrees where iris structures were absent. RESULTS: Ten weeks after TALC, the patient's IOP remained controlled with medications at 16 mmHg, and visual acuity had improved to 20/25 with an aphakic contact lens. CONCLUSION: In selected patients whose ciliary processes are visible with indirect gonioscopy due to the defect in the iris, TALC may be an effective alternative cyclodestructive procedure to lower IOP when conventional medical or laser treatments are not successful.

Adult↗