RESUMEN
BACKGROUND: The aim of present study is to compare the effectiveness, side-effect potential of different doses of sericin pleurodesis. METHODS: Adult, male, 12-week-old, Wistar-albino rats (n = 52), were randomly-divided into four-groups, referred to A, B, C and D. Sericin was administrated at different doses through left thoracotomy, with 15mg sericin to Group-A, 30 mg to Group-B and 45 mg to Group-C. Group-D was assigned as control group. The rats were sacrificed 12 days later. Left-hemithorax, heart, liver and kidney were examined pathologically. RESULTS: No foreign body reaction in the parenchyma was observed in any of the rats, while emphysema was least common in Group-B (P < .05). Multi-layer mesothelium of both pleura was most common in Group-B, while fibrosis and fibrin organization within the visceral-pleura was more successful in all of sericin treated groups than in control group (P < .05), with neither Group-A, Group-B nor Group-C being superior to each other. In the examination of collagen fibers using Masson's trichrome, "dense collagen fibers" were found in all three sericin treated groups, and differences between Groups-A, -B, -C and the control group were significant (P < .05). The probability of observing pyknotic nucleus and balloon degeneration in liver increased with increasing sericin doses (P < .05). Glomerular degeneration in kidney and the findings of pericarditis were most common in Group-C (P < .05). CONCLUSION: The target should be to maximize efficacy while minimizing the likelihood of side-effects. The intrapleural administration of sericin 30 mg performs better due to multi-layer mesothelial reaction being higher and emphysema being lower in Group-B, to the fewer side-effects affecting the kidney and heart, and liver toxicity not being higher
INTRODUCCIÓN: El objetivo de este estudio es comparar la efectividad y los posibles efectos secundarios de diferentes dosis del agente pleurodésico sericina. MÉTODOS: Se utilizaron ratas macho albinas Wistar de 12 meses de edad (n = 52) que se dividieron aleatoriamente en 4 grupos, referidos como A, B, C y D. Se administró sericina a diferentes dosis a través de toracotomía izquierda: 15 mg al grupo A, 30 mg al grupo B y 45 mg al grupo C. El grupo D se utilizó como grupo control. Las ratas se sacrificaron 12 días más tarde. Se realizó examen patológico del hemitórax izquierdo, el hígado y el riñón. RESULTADOS: No se observaron reacciones a cuerpo extraño en el parénquima de ninguna de las ratas. El enfisema fue menos común en el grupo B (p < 0,05). El mesotelio multicapa en ambas pleuras fue más frecuente en el grupo B, mientras que la fibrosis y la organización de la fibrina en la pleura visceral tuvieron una mayor tasa de éxito en todos los grupos tratados con sericina que en el control (p < 0,05), sin ser mayor en ninguno de los grupos. Cuando se examinaron las fibras de colágeno mediante el tricrómico de Masson, se encontraron «fibras densas de colágeno» en los 3 grupos tratados con sericina, existiendo diferencias significativas entre los grupos A, B y C (p < 0,05). La probabilidad de observar núcleos picnóticos y degeneración «en globo» en el hígado se incrementó con el aumento de las dosis de sericina (p < 0,05). La degeneración glomerular en el riñón, y los hallazgos de pericarditis fueron más frecuentes en el grupo C (p < 0,05). CONCLUSIÓN: El objetivo debería ser maximizar la eficacia a la vez que se minimiza la probabilidad de efectos secundarios. La administración intrapleural de 30 mg de sericina resulta más eficaz debido a una mayor reacción mesotelial multicapa y a menor incidencia de enfisema (como se observa en el grupo B), así como a un menor número de efectos adversos que afectan al riñón y al corazón sin incremento concomitante de la toxicidad hepática
Asunto(s)
Animales , Masculino , Ratas , Pleurodesia/métodos , Sericinas/administración & dosificación , Relación Dosis-Respuesta a Droga , Sericinas/efectos adversos , Modelos Animales , Ratas WistarRESUMEN
BACKGROUND: The aim of present study is to compare the effectiveness, side-effect potential of different doses of sericin pleurodesis. METHODS: Adult, male, 12-week-old, Wistar-albino rats (n=52), were randomly-divided into four-groups, referred to A, B, C and D. Sericin was administrated at different doses through left thoracotomy, with 15mg sericin to Group-A, 30mg to Group-B and 45mg to Group-C. Group-D was assigned as control group. The rats were sacrificed 12 days later. Left-hemithorax, heart, liver and kidney were examined pathologically. RESULTS: No foreign body reaction in the parenchyma was observed in any of the rats, while emphysema was least common in Group-B (P<.05). Multi-layer mesothelium of both pleura was most common in Group-B, while fibrosis and fibrin organization within the visceral-pleura was more successful in all of sericin treated groups than in control group (P<.05), with neither Group-A, Group-B nor Group-C being superior to each other. In the examination of collagen fibers using Masson's trichrome, "dense collagen fibers" were found in all three sericin treated groups, and differences between Groups-A, -B, -C and the control group were significant (P<.05). The probability of observing pyknotic nucleus and balloon degeneration in liver increased with increasing sericin doses (P<.05). Glomerular degeneration in kidney and the findings of pericarditis were most common in Group-C (P<.05). CONCLUSION: The target should be to maximize efficacy while minimizing the likelihood of side-effects. The intrapleural administration of sericin 30mg performs better due to multi-layer mesothelial reaction being higher and emphysema being lower in Group-B, to the fewer side-effects affecting the kidney and heart, and liver toxicity not being higher.
Asunto(s)
Pleurodesia , Sericinas , Animales , Colágeno , Masculino , Pleura , Ratas , Ratas WistarRESUMEN
Introduction: The usefulness of sericin as pleurodesis agent has previously been described. Present study aims to compare sericin pleurodesis regarding success, effectiveness, tolerability, and side-effects. Methods: Adult, 12-week-old Wistar-albino rats (n = 60), divided to five groups as sericin, talcum-powder, doxycycline, silver-nitrate and control. Agents were administrated through left thoracotomy, rats sacrificed twelve-days after. Results: Highest ratio of collagen fibers was observed in sericin group, and the intensity was higher than talcum-powder group (p < 0.05). Compared to silver nitrate, sericin group displayed better mesothelial reaction, and multi-layer mesothelium was also better (p < 0.05). Foreign body reaction and emphysema were less frequent in sericin group (p < 0.05). The presence of biological tissue in parenchyma was less prominent in sericin group (p < 0.05). Foreign body reaction on thoracic wall was less common in sericin group (p < 0.05). Presence of biological tissue glue in thoracic wall was less prominent in sericin group (p < 0.05). Glomerular degeneration was lower in sericin group compared to the silver nitrate group (p < 0.05), and tubular degeneration was less common in sericin group than talcum group (p < 0.05). Pericarditis was less common in sericin group compared to the other groups (p < 0.05). Conclusion: As an intrinsic, natural glue protein, sericin protects the lung parenchyma and tissues, and its glue-like characteristics enable pleurodesis. The success of sericin in pleurodesis was demonstrated in the present study based on investigations of the pleurae. Being cost-effective and better tolerated agent associated with a low potential of side effects, sericin is more effective, less expensive and provides more lung parenchyma protection
Introducción: La utilidad de la sericina como agente pleurodésico se ha descrito previamente. El objetivo de este estudio es evaluar el éxito, efectividad, tolerabilidad y efectos secundarios de la pleurodesis con sericina. Métodos: Ratas adultas albinas Wistar de 12 semanas (n = 60) se dividieron en cinco grupos de tratamiento: sericina, polvos de talco, doxiciclina, nitrato de plata y control. Los agentes se administraron por toracotomía izquierda. Las ratas se sacrificaron 12 días después. Resultados: se observó la mayor proporción de fibras de colágeno en el grupo de sericina, con intensidad superior a la del grupo de talco (p < 0,05). Comparado con el nitrato de plata, el grupo de sericina mostró mejor reacción mesotelial y mejor mesotelio multicapa (p<0,05). La reacción a cuerpo extraño y el enfisema fueron menos frecuentes en el grupo de sericina (p < 0,05). Se halló menor cantidad de tejido biológico en el parénquima en el grupo de sericina (p < 0,05). La reacción a cuerpo extraño en la pared torácica fue menos frecuente en el grupo de sericina (p < 0,05). Se halló menor cantidad de adhesivo tisular de origen biológico en la pared torácica en el grupo de sericina (p < 0,05). La degeneración glomerular fue menor en el grupo de sericina en comparación con el grupo de nitrato de plata (p < 0.05), y la degeneración tubular fue menos frecuente en el grupo de sericina que en el grupo de talco (p < 0.05). También la pericarditis fue menos frecuente en el grupo de sericina en comparación con los otros grupos (p < 0.05). Conclusión: Como proteína adhesiva natural intrínseca, la sericina protege al parénquima pulmonar y a los tejidos, de modo que sus características adhesivas son adecuadas para la pleurodesis. En este estudio se demuestra la utilidad de la sericina en la pleurodesis gracias a investigaciones de la pleura. Siendo un agente más coste-efectivo y mejor tolerado, la sericina es más efectiva, más barata y proporciona mayor protección del parénquima pulmonar
Asunto(s)
Animales , Ratas , Pleurodesia/métodos , Pleura/efectos de los fármacos , Tejido Parenquimatoso/efectos de los fármacos , Sericinas/administración & dosificación , Resultado del Tratamiento , Ratas Wistar , Toracotomía/métodos , Sericinas/farmacología , Talco/administración & dosificación , Nitrato de Plata/administración & dosificaciónRESUMEN
INTRODUCTION: The usefulness of sericin as pleurodesis agent has previously been described. Present study aims to compare sericin pleurodesis regarding success, effectiveness, tolerability, and side-effects. METHODS: Adult, 12-week-old Wistar-albino rats (n=60), divided to five groups as sericin, talcum-powder, doxycycline, silver-nitrate and control. Agents were administrated through left thoracotomy, rats sacrificed twelve-days after. RESULTS: Highest ratio of collagen fibers was observed in sericin group, and the intensity was higher than talcum-powder group (p<0.05). Compared to silver nitrate, sericin group displayed better mesothelial reaction, and multi-layer mesothelium was also better (p<0.05). Foreign body reaction and emphysema were less frequent in sericin group (p<0.05). The presence of biological tissue in parenchyma was less prominent in sericin group (p<0.05). Foreign body reaction on thoracic wall was less common in sericin group (p<0.05). Presence of biological tissue glue in thoracic wall was less prominent in sericin group (p<0.05). Glomerular degeneration was lower in sericin group compared to the silver nitrate group (p<0.05), and tubular degeneration was less common in sericin group than talcum group (p<0.05). Pericarditis was less common in sericin group compared to the other groups (p<0.05). CONCLUSION: As an intrinsic, natural glue protein, sericin protects the lung parenchyma and tissues, and its glue-like characteristics enable pleurodesis. The success of sericin in pleurodesis was demonstrated in the present study based on investigations of the pleurae. Being cost-effective and better tolerated agent associated with a low potential of side effects, sericin is more effective, less expensive and provides more lung parenchyma protection.
Asunto(s)
Doxiciclina/uso terapéutico , Pleurodesia/métodos , Soluciones Esclerosantes/uso terapéutico , Sericinas/uso terapéutico , Nitrato de Plata/uso terapéutico , Talco/uso terapéutico , Animales , Colágeno/análisis , Análisis Costo-Beneficio , Doxiciclina/economía , Doxiciclina/toxicidad , Evaluación Preclínica de Medicamentos , Enfisema/inducido químicamente , Epitelio/efectos de los fármacos , Epitelio/patología , Fibrosis , Reacción a Cuerpo Extraño/inducido químicamente , Pulmón/efectos de los fármacos , Pulmón/patología , Masculino , Miocardio/química , Pleura/efectos de los fármacos , Pleura/patología , Pleurodesia/efectos adversos , Pleurodesia/economía , Ratas , Ratas Wistar , Soluciones Esclerosantes/economía , Soluciones Esclerosantes/toxicidad , Sericinas/economía , Sericinas/toxicidad , Nitrato de Plata/economía , Nitrato de Plata/toxicidad , Talco/economía , Talco/toxicidad , Toracotomía , Vísceras/patologíaRESUMEN
BACKGROUND: This study aims to share our experiences in complications developing in patients who underwent Nuss procedure and the management of these complications. METHODS: In the study, files of 59 patients (50 males, 9 females; mean age 17.6±5.1 years; range, 2.5 to 33 years) who were applied Nuss procedure for pectus excavatum in our clinic between July 2007 and May 2016 were retrospectively assessed. Patients" age, gender, surgical method-complications and hospitalization durations were recorded. Fisher"s chisquare test and logistic regression analysis were used for data evaluation. RESULTS: Nuss procedure was performed in all patients without severe complications such as death, organ injury or massive hemorrhage. The most frequently observed postoperative earlyperiod complication was minimal pneumothorax (n=16, 27.1%), while bar dislocation was most frequently observed in the lateperiod (n=5, 8.3%). CONCLUSION: Being male and/or over 23 years of age were determined as risk factors for complication development after Nuss procedure. Still, being a minimally invasive and manageable approach with its success in correcting the deformity, short operation duration, and low complication rates, Nuss procedure can be safely performed in selected patients.
RESUMEN
Complications of percutaneous pericardial catheter insertion for pericardial effusion are rare. We describe a rare complication of percutaneous pericardial catheter insertion that penetrated the stomach and diaphragm before getting into the pericardial sac in a patient with lymphoma. The misplaced catheter was extracted surgically and subxiphoid pericardial tube insertion with pleural pericardial window was performed.