Comparison of efficacy of heterologous blood, Rifamycin and Talc as sclerosant agent in rabbits

Tavşanlarda plevral sklerozan ajan olarak heterolog kan, rifamycin ve talk'ın etkinliğinin karşılaştırılması (Deneysel çalışmaAmaç: Bu çalışmada plörodezisde etkin olabileceğini düşündüğümüz kolay bulunabilir, düşük maliyetli ve yan etki potansiyeli olmayan iki yeni ajan olarak rifamycin ve heterolog kanın plörodezis etkinliğini talk ile karşılaştırmayı amaçladıkGereç ve yöntem: Çalışmada 21 adet Yeni Zelanda türü albino erkek veya dişi tavşan kullanıldı. Tavşanlar 4 gruba ayrıldı. Her bir gruptaki tavşan sayısı eşitti (N=5). Bir adet tavşan taze kan temininde kullanıldı. Birinci grup kontrol, ikinci grup heterolog kan, üçüncü grup rifamycin, dördüncü grup talk grubu idi. Sol hemitoraksa 16F toraks kateteri takılıp kontrol PA akciğer filmleri alındı. Her gruba ayrı ayrı ilaçları verildi. Bir saatlik gözlemin ardından dren aspire edilerek çekildi ve 28 günlük takibe alındı. Tavşanlar yüksek doz anestezi ile sakrifiye edilerek sol hemitorakstaki yapışıklıklar sternotomi yapılarak makroskobik ve mikroskobik olarak incelendiBulgular: Kontrol grubunun hepsinde makroskobik incelemede skor 0, mikroskobik incelemede üçünde skor 0, ikisinde skor 1 bulundu. Heterolog kan grubunda makroskobik incelemede ikisinde skor 0, ikisinde skor 1 birinde skor 2, mikroskobik incelemede ikisinde skor 0, ikisinde skor 1, birinde skor 2 bulundu. Rifamycin grubununda makroskobik incelemede dördünde skor 4, birinde skor 3, mikroskobik incelemede dördünde skor 4, birinde skor 3 bulundu. Talk grubununda makroskobik incelemede ikisinde skor 4, birinde skor 3, ikisinde skor 2, mikroskobik incelemede üçünde skor 4, ikisinde skor 3 bulundu. Fakat talk grubunda makroskobik ve mikroskobik tam obliterasyon gösteren iki tavşanda akciğer absesi geliştiği gözlendiİstatistiksel olarak makroskobik kontrol grubu ile heterolog kan, rifamycin ve talk grubu arasında anlamlı fark vardı (P = 0,04). Talk grubu ile rifamycin grubu arasında anlamlı fark tespit edilmedi (P > 0,05). İstatistiksel olarak makroskobik ve mikroskobik kontrol grubu ile heterolog kan grubu arasında anlamlı fark yoktu (P > 0,05). Kontrol grubu ile rifamycin ve talk grubu arasında anlamlı fark vardı (P = 0,04). Talk grubu ile rifamycin grubu arasında anlamlı fark tespit edilmedi (P > 0,05Sonuç: Rifamycin'in makroskobik ve mikroskobik olarak diğer grublara göre plevral aralıkta daha iyi yapışıklık, inflamasyon ve fibrozis oluşturduğunu, rifamycin'in doz ayarı ve klinik kullanımı konusunda yapılacak olan yeni çalışmalar ışığında, plörodezisde kullanılabilecek ajanlar arasında yer alması gerektiği kanısına vardıkAnahtar kelimeler: Plörodezis; Rifamycin; Heterolog kan; Talk.Comparison of efficacy of heterologous blood, rifamycin and talk as sclerosant agent in rabbits (experimental study)Aim: In this study we aimed to compare the efficacy of rifamycin and heterologous blood, which are easily found, cheaper, have low side effect potential and thought to be effective in pleurodesis, with talk.Materials and method: In this study 21 New Zeland type albino male or female rabbits were used. Rabbits were divided into four groups (n=5). The number of the rabbits was equal in each group. One rabbit was used in fresh blood supply. First group was control, second one was heterologous blood, third group rifamycin and fourth group was talk group. Control PA chest roentgenogram was obtained after inserting 16F thorax catheter to left hemi thorax. Every group received their medicines. After one hour of follow up, drain was pulled out and rabbits were followed for 28 days. The rabbits were sacrificed with high dose anesthesia and after applying sternotomy to adhesions at left hemi thorax, macroscopic and microscopic examination of samples were doneFindings: Macroscopic score was 0 in all members of control group; microscopic score was 0 in three and 1 in two of the rabbits in control group. In heterologous blood group macroscopic score was 0 in two, 1 in two and 2 in one rabbit, microscopic score was also 0 in two, 1 in two and 2 in one rabbit. In rifamycin group macroscopic score was 4 in four and 3 in one rabbit, microscopic score was also 4 in four and 3 in one rabbit. In talk group macroscopic score was 4 in two, 3 in one and 2 in two rabbits; microscopic score was 4 in three and 3 in two rabbits. However lung abscess was demonstrated in two rabbits with complete macroscopic and microscopic obliterationStatistically, there was significant difference between control group and, heterologous blood, rifamycin and talk groups (p = 0,04). No significant difference was present between talk and rifamycin group (p > 0,05). Statistically no difference was observed between macroscopic and microscopic control group and heterologous blood group (p > 0,05). Significant difference was found between control group and rifamycin and talk groups (p = 0,04). No significant difference was present between talk and rifamycin group (p > 0,05).Conclusion: We think that macroscopically and microscopically rifamycin makes up better adhesion, inflammation and fibrosis in pleural space and in the light of further studies about dose adjustment and clinical usage, rifamycin can be placed among the agents used in pleurodesis.Key words: Pleurodesis, rifamycin, heterologous blood, talk

Mezotelyoma ve plevral plaklı hastaların çevresel asbest maruziyeti yaşamış sağlıklı bireylere kıyasla serum biyokimyasal belirteçlerin karşılaştırılması

Background: In this study, we aimed to compare serum biochemical markers in patients with malignant pleural mesothelioma and pleural plaques versus healthy individuals exposed to environmental asbestos. Methods: Between September 01, 2010 and March 31, 2011, a total of 540 participants (354 males, 186 females; mean age 61.4 years; range, 35 to 89 years) were included in the study. The participants were divided into four groups as follows: (1) patients with pleural plaques (n=277); (2) healthy individuals with normal chest X-rays who were exposed to environmental asbestos (n=121); (3) healthy individuals with normal chest X-rays who were not exposed to environmental asbestos (n=118); and (4) patients with malignant pleural mesothelioma (n=24). Serum levels of carcinoembryonic antigen, cancer antigen 125, 15-3, 19-9, free T3, free T4, thyroidstimulating hormone, vitamin B12, folate, and ferritin were measured. Results: Serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels were higher with lower free T3 levels in Group 4 than the other groups. The areas under the curve for cancer antigen 125 and 15-3 were 0.78 and 0.67, respectively in the differential diagnosis of mesothelioma from other pathologies (p < 0.001 for both). Optimal limits of these biomarkers were 13.63 and 18.43 ng/mL, respectively with 83% and 75% sensitivity and 69% and 48% specificity, respectively. Conclusion: The combination or individual use of serum cancer antigen 125, 15-3, folic acid, vitamin B12, and ferritin levels may be helpful for early diagnosis and treatment of malignant pleural mesothelioma.Amaç: Bu çalışmada mezotelyoma ve plevral plaklı hastaların çevresel asbest maruziyeti yaşamış sağlıklı bireylere kıyasla serum biyokimyasal belirteçleri karşılaştırıldı. Ça­lış­ma pla­nı: 01 Eylül 2010 - 31 Mart 2011 tarihleri arasında toplam 540 katılımcı (354 erkek, 186 kadın; ort. yaş 61.4 yıl; dağılım, 35-89 yıl) çalışmaya alındı. Katılımcılar dört gruba ayrıldı: (1) plevral plaklı hastalar (n=277); (2) çevresel asbeste maruz kalıp göğüs röntgenleri normal olan sağlıklı bireyler (n=121); (3) çevresel asbeste maruz kalmadan göğüs röntgenleri normal olan sağlıklı bireyler (n=118) ve (4) malign plevral mezotelyomalı hastalar (n=24). Serumda karsinoembriyonik antijen, kanser antijeni 125, 15-3, 19-9, serbest T3, serbest T4, tiroid stimülan hormon, B12 vitamini, folik asit ve ferritin düzeyleri ölçüldü. Bulgular: Diğer gruplara kıyasla, Grup 4’te serum kanser antijeni 125, 15-3, folik asit, B12 vitamini ve ferritin düzeyleri daha yüksek ve serbest T3 düzeyleri daha düşük idi. Mezotelyomanın diğer patolojilerden ayırıcı tanısında kanser antijeni 125 ve 15-3’ün eğri altında kalan alanı sırasıyla 0.78 ve 0.67 idi (her ikisi için de p<0.001). Bu biyobelirteçlerin optimum sınırı sırasıyla 13.63 ve 18.43 ng/mL olup, duyarlılıkları sırasıyla %83 ve %75 ve özgüllükleri %69 ve %48 idi. So­nuç: Serum kanser antijeni 125, 15-3, folik asit, B12 vitamini ve ferritin düzeylerinin birlikte veya tek başına kullanımı, malign plevral mezotelyomanın erken tanı ve tedavisinde yararlı olabilir

Bronchial carcinoid tumor with vascular supply from thoracic aorta

Bronchial carcinoid tumors are neuroendocrine tumors which account for approximately 1% of tracheobronchial tree tumors. Symptoms depend on localization and size of tumor or secreting neuroendocrine hormones. In this article, we report a 48-year-old female case who was admitted with dyspnea, retrosternal pain and asthma-like symptoms. Computed tomography revealed a centrally located mass lesion with vascular supply from an aberrant artery arising from the thoracic aorta. No endobronchial lesion was present on bronchoscopy. Left thoracotomy was performed and aberrant artery was ligated and cut. Left lower lobectomy and mediastinal lymph node dissection were performed. Histopathological examination revealed a typical carcinoid tumor without lymph node invasion. After a 21-month follow-up, she is clinically well without recurrence

Pulmonary sublobar resections in pediatric patients

Background: This study aims to evaluate the outcomes of pulmonary sublobar resection in pediatric patients