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Biomedical subjects

M Sok

Publications and source records attributed to M Sok.

9 recordsLinked to original sources

Impact of pleural effusion pH on the efficacy of thoracoscopic mechanical pleurodesis in patients with breast carcinoma.

OBJECTIVE: A prospective randomised study was conducted to compare the efficacy of treating malignant pleural effusions (MPE) in patients with breast carcinoma by thoracoscopic mechanical pleurodesis (TMP) as a new palliative treatment and talc pleurodesis (TP) at various pleural fluid pH levels and to determine whether at low pH values, when the success of TP is reduced, TMP is more successful. METHODS: 87 female patients with breast carcinoma and a resulting MPE resistant to systemic therapy were divided into two groups: TMP and TP groups. In the TMP group 24 patients with pH levels above 7.3 and 21 patients with pH levels below 7.3 underwent thoracoscopic parietal and visceral pleural abrasion utilising general anaesthesia. In the TP group, 22 patients with pH levels above 7.3 and 20 patients with pH levels below 7.3 were administered 5 g of sterile talc, dissolved in 100 ml of physiological solution, via a chest tube, utilising local anaesthesia. Postoperative follow-up was performed to determine a possible recurrence of MPE with periodic radiographs, the duration of chest tube drainage and hospitalisation, occurrence of complications, and perioperative mortality. The following was used for statistical analysis: t-test for odd samples, chi2 test, logistic regression, and multiple linear regression. RESULTS: TMP and TP were equally successful (92 and 91%) in patients with pH levels above 7.3. Differences occurred in patients with pH below 7.3 (81 and 55%) (P = 0.07). The lowest pH value at which TMP proved successful was 7.06, while for TP this value was 7.25. In TMP group the average duration of chest tube drainage amounted to 3.8 days and hospitalisation to 5.5 days, while in TP group it was 5.6 and 7.5 days, respectively. Differences were statistically significant (P < 0.05). 16% of easily treatable complications and no case of perioperative mortality were identified in TMP group, while 26% of complications and four cases of perioperative mortality were noted in TP group. CONCLUSIONS: TMP is a safe palliative treatment for MPE in breast carcinoma, with a minimal number of complications and a short hospital stay; it is more successful than TP in patients with pH of MPE below 7.3.

Breast Neoplasms↗

Sources of pathogens causing pleuropulmonary infections after lung cancer resection.

OBJECTIVE: The source of pathogens responsible for pleuropulmonary complications after lung resection is not yet completely understood, yet knowing this source is very important for proper perioperative use of antibiotics in lung surgery. We studied prospectively the value of sputum samples -- collected 3 days before and 3 days after surgery -- and of intraoperative bronchial swabs in the diagnosis of infective pulmonary complications following lung cancer resection. METHODS: In a prospective trial, we studied 194 patients (18 women and 176 men, age range 34-79 years, mean 57 years) who were operated on for lung cancer. The infection screen consisted of intraoperative bronchial swabs, and sputum samples obtained prior to and 3 days after surgery. Before the operation, all patients were free of clinical signs of respiratory infection. In patients with postoperative infection, causative pathogens were identified from sputum, tracheal aspirate, thoracic puncture and thoracic drainage fluids. RESULTS: Thirty-four patients suffered from 32 pleuropulmonary infections, and two from wound infection. Pathogenic organisms were isolated from preoperative and postoperative sputum samples and from intraoperative bronchial swabs in 50, 64 and 27% of patients, respectively. Postoperative infective complications were caused by gram-negative bacteria and Candida albicans in 75% of patients. These potential pathogens were recovered from preoperative sputum samples and from intraoperative bronchial swabs in only 18 and 13% of cases, but from postoperative sputum samples in 63% of cases. A strong correlation in identified pathogens was found between the postoperative sputum samples and the samples collected for microbiological diagnosis of subsequent postoperative infective complications (P<0.01). CONCLUSIONS: Our results indicate that pathogens that cause pleuropulmonary infective complications are probably acquired postoperatively from the patient's oral cavity, pharynx and hypopharynx. Appropriate antibiotic prophylaxis is discussed.

Adult↗

Onset of spontaneous pneumothorax and the synodic lunar cycle.

The relation between spontaneous pneumothorax events and synodic lunar cycle was studied in a retrospective analysis of patients with a first or recurrent spontaneous pneumothorax. The study included a total of 244 patients, 203 males and 41 females. The data were arranged along the first (new moon) to 28th day (one day before another new moon) of the synodic lunar cycle. Periodogram analysis revealed a 14-day rhythm, significant for the male and pooled sample. Cosinor analysis found the whole synodic lunar cycle and its 2nd, 4th and 5th harmonics as significant. Maximal accumulation of cases happened 1 week before and 1 week after the new moon. Mechanisms of a putative moon influence are not clear.

Female↗

Membrane fluidity characteristics of human lung cancer.

Membrane fluidity of non-cultured lung cancer tissue was studied by electron paramagnetic resonance (EPR). EPR spectra of a lipophilic spin probe in a tissue of resected tumor samples from 51 patients were compared with computer simulated spectra, which were superimpositions of spectra characterizing membrane domains with different fluidity. The membranes of tumor tissues were more fluid, than those of normal lungs; the most fluid domains were enlarged and their order parameter decreased in comparison to normal tissue. An empirical fluidity parameter (H13) was defined as the criterion to correlate EPR and clinical data. The histology of tumor, the quantitative presence of different tumor and non-tumor cells and the pathohisthological stage of the disease had no significant influence on fluidity.

Carcinoma, Non-Small-Cell Lung↗

Unusual ECG variations in left-sided pneumothorax.

A patient with spontaneous left-sided pneumothorax and unusual, phasic voltage variations in the electrocardiogram (ECG), which fluctuated depending on respiration, was observed. After intercostal tube drainage, these variations disappeared. The respiratory changes in the thorax seem to be a cause of these ECG findings.

Adult↗