SEARCH · PubMed Health

Results for “MM”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed1995

Pharmacological properties of MM-706, a new prostacyclin derivative.

1. In human platelet-rich plasma, platelet aggregation induced in vitro by collagen (10 micrograms/ml) or thrombin (50 mU/ml) was dose-dependently inhibited by increasing concentrations of prostacyclin or of the new derivative (+/-)(5E)-13,14-didehydro-omega-hexanor(1-hydroxycyclo hexyl)-9a- carbaprostacyclin (MM-706) with an IC50 of 20-50 nM and 250-500 nM, respectively. In human platelets loaded with fura-2, the intracellular rise of [Ca2+] induced by thrombin was dose-dependently inhibited by MM-706 with an approximate IC50 of 100 microM. 2. In rabbit isolated femoral artery, MM-706 (10 nM-10 microM) was completely ineffective in relaxing the vessel, which was different to prostacyclin which was able to relax vessels at the same concentrations. 3. In in vitro guinea-pig ileum, prostacyclin produced a contractile effect in the concentration range 1 nM-10 microM, but the derivative MM-706 was ineffective at the same concentrations. Preventive addition of MM-706 did not inhibit prostacyclin contraction. 4. On isolated guinea-pig tracheal preparation, prostacyclin induced a concentration-dependent contraction but the new compound MM-706 showed a lower activity, in the concentration range 10 nM-10 microM. The activity of prostacyclin was not affected by the contemporary presence of MM-706. 5. It is concluded that MM-706 is a prostacyclin analogue with antiaggregating properties but without evident effects on smooth muscle of different regions.

Animals↗

PubMed1991

Comparison of a 3- and 6-mm incision in combined phacoemulsification and trabeculectomy.

We studied 216 eyes of 160 patients who underwent combined phacoemulsification and posterior chamber intraocular lens implantation with trabeculectomy. The mean follow-up was 18.7 months, with a minimum follow-up of six months. To assess the safety and efficacy of a recently developed 3-mm incision procedure with foldable intraocular lens implantation (phacotrabeculectomy), we compared 104 eyes subjected to this procedure with 112 eyes subjected to a 6-mm procedure at different follow-up periods. Intraocular pressure control (less than 21 mm Hg) was attained in 44 of 46 eyes (96%) in the 3-mm group and 71 of 76 eyes (93%) in the 6-mm group at one year postoperatively. Visual acuity of 20/40 or better was attained in 40 of 46 eyes (87%) in the 3-mm group and 66 of 76 eyes (87%) in the 6-mm group. The incidence of postoperative complication was significantly lower (P less than .001) and visual acuity in the early postoperative period was significantly better (P less than .01) in the 3-mm incision group than in the comparison group.

Adult↗

PubMed1988

Carbon dioxide laser laparoscopy by means of a 3.0-mm diameter rigid wave guide.

Rigid carbon dioxide wave guides measuring 300 to 500 mm in length and 3.0 mm in diameter were evaluated in rabbits and humans. The wave guide provided an effective laser delivery system for operative laparoscopy. The tested guide was introduced into the abdominal cavity alternatively via the operating channel of a 9-mm operating laparoscope, through the central channel of a smoke evacuation/irrigation cannula, or via a 3.25-mm second puncture trocar. In contrast to previously tested flexible guides, the rigid device transmitted a visible helium-neon aiming beam, power up to 50 watts, and a beam diameter of less than 1 mm. The hollow guide was kept free of smoke by-products by continuous purging with carbon dioxide gas flowing at 800 to 1000 cc per minute. All wave guides could be sterilized by ethylene oxide gas or Cidex (Surgikos, Arlington, TX) soaking. Fourteen women with a variety of reproductive disorders underwent laser laparoscopy. The rigid wave guide was fired at distances ranging from less than 1 mm to 30 mm from the target and performed with maximal impact at distances of 3 to 5 mm. Perhaps the greatest advantage of this system is its ability to focus-defocus while directly coupling to the handpiece of standard lasers and requiring no special alignment procedures.

Animals↗

PubMed2003

The risk of regional lymph node metastases in patients with melanoma less than 1.0 mm thick: recommendations for sentinel lymph node biopsy.

BACKGROUND: Lymphatic mapping and sentinel lymph node biopsy can upstage patients with intermediate thickness (1.0 to 4.0 mm) melanoma. Currently, there are no strict guidelines for sentinel lymph node biopsy in patients with melanoma <1.0 mm thick. STUDY DESIGN: A retrospective review of our patient database (598 patients treated at two institutions in Baltimore, MD, between January 1970 and June 2002) was performed to identify patients with primary cutaneous melanoma <1.0 mm thick who developed recurrent disease. This cohort of patients with > or =5 years of followup from the date of diagnosis was compared with patients with primary melanoma of similar thickness and similar followup intervals without recurrent disease. RESULTS: A total of 114 patients with primary cutaneous melanoma <1.0 mm thick were identified, 17 of whom developed disease recurrence. In 13 patients, the site of first recurrence was the regional lymph nodes and in 4 patients disease recurred with distant metastases. The median time to lymph node recurrence was 55 months (range 2 to 112) months. Patients with regional lymph node recurrences had a significant (p = 0.02) difference in median primary tumor thickness of 0.80 mm versus 0.45 mm in patients without recurrent disease; there was no association of Clark level of invasion to recurrence (p = 0.42). In all, 35% of patients (7 of 20) presenting with melanoma 0.80 to 0.99 mm thick developed lymph node recurrence a median of 41 months (range 8 to 112 months) after surgical treatment. CONCLUSIONS: Sentinel lymph node biopsy can be justified for patients with melanoma > or =0.8 mm thick provided that the technique would detect metastatic disease years before it becomes clinically evident.

Adolescent↗

PubMed2003

Mechanisms of cell death and survival in multiple myeloma (MM): Therapeutic implications.

Multiple myeloma (MM), a hematologic malignancy, remains fatal despite all available therapies. Initial treatment with conventional drugs effectively induces MM cell death/apoptosis; however, prolonged drug exposures results in the development of de novo chemoresistance. Because MM is a bone marrow (BM) cancer, the progression of disease and drug efficacy is highly influenced by the BM microenvironment. Novel agents, such as proteasome inhibitors (PS-341), 2-methoxyestradiol (2ME2), thalidomide and its immunomodulatory derivatives (IMiDs), and histone deacetylase (HDAC) inhibitors target the MM cell in its BM microenvironment; thereby enhancing anti-MM activity as well as preventing development of drug-resistance. The transcriptional events and signaling pathways, which mediate these responses in MM cells are now being delineated, and may serve to identify novel therapeutic targets based upon interrupting MM cell growth or triggering MM cell death.

Antineoplastic Agents↗

PubMed2002

Prospective randomized comparison of closed cooled-tip versus 8-mm-tip catheters for radiofrequency ablation of typical atrial flutter.

INTRODUCTION: Cooled-tip and 8-mm-tip catheters have been found to be more effective than conventional 4-mm-tip catheters for radiofrequency (RF) ablation of common atrial flutter. The aim of this study was to compare the efficacy and safety of cooled-tip and 8-mm-tip catheters for flutter ablation in a randomized, prospective study. METHODS AND RESULTS: In 100 consecutive patients referred for ablation of common atrial flutter, cavotricuspid ablation was performed with a closed cooled-tip catheter (n = 50) or an 8-mm-tip ablation catheter (n = 50). RF current was applied for 60 to 120 seconds at powers of 40 to 50 W with the closed cooled-tip catheter and in a temperature-controlled mode (65 degrees C/70 W) with the 8-mm-tip catheter. The endpoint was achievement of a bidirectional isthmus conduction block. Cross-over was performed after 15 unsuccessful RF applications for each of the catheters. Complete bidirectional isthmus block was achieved in 99% of patients. Cross-over was performed in 11 patients after primary use of the cooled-tip catheter and in 9 patients after primary ablation with the 8-mm-tip catheter. No significant differences were found in the procedure parameters, such as overall RF applications (12.4 +/- 11.3 vs 12.9 +/- 8.6), ablation duration (42 +/- 43 min vs 39 +/- 27 min), and fluoroscopy time (17.0 +/- 18.7 min vs 15.7 +/- 10.7 min). In a mean follow-up of 8.3 months, 1 patient in the cooled-tip group and 3 patients in the 8-mm-tip group had recurrence of common atrial flutter. CONCLUSION: Use of the closed cooled-tip ablation catheter and the 8-mm-tip catheter have equal and high efficacy for RF ablation of common atrial flutter.

Aged↗

PubMed2005

Hemodynamic performance and clinical consequences of aortic valve replacement with 21-mm sized pericardial bioprostheses.

BACKGROUND: Aortic valve replacement (AVR) with a 21-mm sized bioprothesis is still discussed controversially. Since better results have been reported for pericardial valves, the aim of the current study was to analyze the hemodynamic performance as well as clinical parameters in our patients and to compare pericardial and standard porcine valves in particular. METHODS: 342 patients underwent AVR with a bioprosthesis between 1987 and 2000. A 21 mm prosthesis was used in 39 patients (group S), while 303 patients received at least a 23-mm sized valve (group L). Group S was further divided into 19 patients with a pericardial valve (group S1) and 20 patients with a standard porcine valve (group S2). The hemodynamic and clinical parameters were studied in all three groups. RESULTS: The peak and mean transprosthetic gradients were significantly lower in the pericardial group than in the porcine group, particularly between patients with 21 mm valves (peak/mean: S1: 24 +/- 9/20.8 +/- 6.5 mm Hg vs. S2: 38 +/- 15/33 +/- 9 mm Hg, p < 0.05) at discharge. We could also observe that the peak transprosthetic gradient 7 days postoperatively was not significantly higher in patients with a 21 mm pericardial valve compared to group L patients. Comparing clinical parameters, we found significantly more cerebral ischemic events, a prolonged mechanical ventilation, a higher mortality and a longer stay in hospital in the group S2 compared to the group S1. CONCLUSION: The current study shows that pericardial valves perform well, particularly in patients with small aortic roots. Postoperative hemodynamics and clinical results were better than for comparable standard porcine valves. As the outcome of patients with a 21 mm pericardial valve was no worse than that in patients with bigger valves, enlarging procedures for the aortic root are not necessary in the majority of these patients.

Animals↗

PubMed1983

Does the gas exchange anaerobic threshold occur at a fixed blood lactate concentration of 2 or 4 mM?

The anaerobic threshold (theta an) is defined as the VO2 at which blood lactate concentration [lactate] begins to systematically increase (lactate "break point") during incremental exercise. Numerous studies have shown that gas exchange break points at the anaerobic threshold correlate highly (r congruent to 0.90) with the lactate break point. Recently, it has been suggested that the anaerobic threshold occurs at a fixed [lactate] of 2 mM or 4 mM. We therefore compared the gas exchange theta an to the three lactate criteria (break point, 2 mM, and 4 mM) for theta an estimation. Fourteen subjects performed an incremental cycle ergometer test. Ventilation and gas exchange were computed every 30 s. During the same 30-s intervals, venous blood was sampled for [lactate]. Four criteria were used for theta an determination: (1) systematic increase in VE/VO2, without a concomitant increase in VE/VCO2; (2) lactate break point; (3) 2 mM [lactate]; and (4) 4 mM [lactate]. Relative to the gas exchange criterion (i.e., #1), theta an was higher by 44, 280, and 1028 ml X min-1 for the three lactate criteria, respectively; the last two being significantly different (P less than 0.05). Thus, the anaerobic threshold discerned from gas exchange or the lactate break point does not correspond with a fixed, absolute [lactate] of 2 mM or 4 mM.

Adult↗

PubMed1997

The N-terminal moiety of CDC25(Mm), a GDP/GTP exchange factor of Ras proteins, controls the activity of the catalytic domain. Modulation by calmodulin and calpain.

This work describes the in vitro properties of full-length CDC25(Mm) (1262 amino acid residues), a GDP/GTP exchange factor (GEF) of H-ras p21. CDC25(Mm), isolated as a recombinant protein in Escherichia coli and purified by various chromatographic methods, could stimulate the H-ras p21.GDP dissociation rate; however, its specific activity was 25 times lower than that of the isolated catalytic domain comprising the last C-terminal 285 residues (C-CDC25(Mm285)) and 5 times lower than the activity of the C-terminal half-molecule (631 residues). This reveals a negative regulation of the catalytic domain by other domains of the molecule. Accordingly, the GEF activity of CDC25(Mm) was increased severalfold by the Ca2+-dependent protease calpain that cleaves around a PEST-like region (residues 798-853), producing C-terminal fragments of 43-56 kDa. In agreement with the presence of an IQ motif on CDC25(Mm) (residues 202-229), calmodulin interacted functionally with the exchange factor. Depending on the calmodulin concentration an inhibition up to 50% of the CDC25(Mm)-induced nucleotide exchange activity on H-ras p21 was observed, an effect requiring Ca2+ ions. Calmodulin also inhibited C-CDC25(Mm285) but with a approximately 100 times higher IC50 than in the case of CDC25(Mm) ( approximately 10 microM versus 0.1 microM, respectively). Together, these results emphasize the role of the other domains of CDC25(Mm) in controlling the activity of the catalytic domain and support the involvement of calmodulin and calpain in the in vivo regulation of the CDC25(Mm) activity.

Animals↗

PubMed2001

Total knee arthroplasty with 4.4 mm of tibial polyethylene: 10-year followup.

A consecutive series of 387, one-piece, 8-mm tibial components were implanted in 313 patients. All tibial prostheses were manufactured with 4.4 mm of polyethylene directly molded to a 3.6 mm cobalt chrome metal baseplate. The average age of the patients at surgery was 70.6 years. From this group, a subset of 116 patients underwent bilateral total knee arthroplasties with an 8-mm tibial component on one side and at least a 10-mm thick tibial component (at least 6.4 mm of polyethylene) on the other side. The followup averaged 10.7 years. Postoperative knee and pain scores average 81.4 points and 47.2 points, respectively. No radiographic polyethylene wear or osteolytic lesions were identified. Tibial radiolucencies were observed in four knees. There were nine failures (2.3%). Three knees were revised for infection. Five knees were revised for metallosis secondary to failure of metal-backed patellas. No loose tibial components were identified. Defining failure as revision for any reason or loosening of any component, Kaplan-Meier survival rates at 5, 10, and 15 years were 98.7%, 95.4%, and 94.3%, respectively. There was no significant difference in clinical scores or survival rates between the knee components with thicker (at least 6.4 mm) or thinner (4.4 mm) polyethylene.

Adult↗

PubMed1997

Changes in serum creatine phosphokinase MM isoenzyme after lumbar spine surgery.

STUDY DESIGN: Serum concentrations of creatine phosphokinase and its isoenzyme were measured serially in 47 patients who underwent lumbar surgery. OBJECTIVE: To analyze the significance of postoperative creatine phosphokinase MM levels as indicators of muscle trauma after lumbar surgery. SUMMARY OF BACKGROUND DATA: The authors of the present study previously have reported on iatrogenic back muscle injury in an animal model and in man. However, the relationship between the change of the creatine phosphokinase MM isoenzyme level and muscle injury after surgery has not been clarified. METHODS: Peripheral venous blood samples were collected serially before surgery, just after surgery, and at 1, 3, 7, 14, and 21 days after surgery. The serum concentration of total creatine phosphokinase and its isoenzymes was measured by agarose gel electrophoresis. The serial postoperative change of the creatine phosphokinase MM isoenzyme concentration was evaluated with respect to age, gender, body weight, types and levels of surgery, and surgery time. RESULTS: Creatine phosphokinase MM activity increased after surgery and reached a maximum value 1 day after surgery, followed by recovery to the normal value 1 week after surgery. The maximum concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery (P = 0.04). It was significantly higher in men than in women (P = 0.02). Serum concentration of creatine phosphokinase MM isoenzyme showed no significant correlation to the extent of muscle exposure and surgery time. CONCLUSION: The time course of postoperative serum creatine phosphokinase MM isoenzyme activity is correlated with the histologic changes of the back muscles after surgery. The concentration of creatine phosphokinase MM isoenzyme in posterior lumbar surgery was significantly higher than that in anterior surgery. It was also significantly higher in men than in women.

Adolescent↗

PubMed2001

Interleaf leakage for 5 and 10 mm dynamic multileaf collimation systems incorporating patient motion.

Use of dynamic multileaf collimation (DMLC) for intensity modulated radiation therapy (IMRT) is accelerating. Delivery systems have the ailment of interleaf leakage (IL). This is compounded by the inefficiency of IMRT delivery, estimated to be a factor of 5 for DMLC. With IL on the order of 4%, it is possible to deliver as much as 20% of the prescribed dose to nonprescribed regions. However, IL is characterized by narrow Gaussian peaks of approximately 0.5-1.0 mm full-width-half-maximum (FWHM). We performed a leakage study for 5 and 10 mm leaf systems, accounting for intratreatment and intertreatment motions. In solid phantoms, film was placed perpendicular to beams. DMLC patterns delivered step-wedged distributions. The same field was duplicated using a collimating jaw in a segmented fashion to obtain baseline data of primary and scatter contributions. Longitudinal shifts up to 4 mm and angulations up to 4 degrees were introduced during beam delivery by running multiple patterns, to arrive at a composite delivery. The intent of these rigid body motion experiments was to replicate patient motion. Clinical IMRT fields using segmented MLC were also tested. Films were scanned and converted to dose. A microionization chamber confirmed film data at discrete points. In all cases shifts diminished IL peak values. In the step-wedge case, the net 18 MV IL peaks diminished from 3.6% to 3.2% for the 10 mm system. The 5 mm system IL values decreased from 4.0% to 3.2% with a 2 mm shift but increased to 4.0% with 4 mm shifts. The clinical field data followed the same pattern with a washing out of peak values, but the overall transmission to shielded regions slightly increased. Therefore nonprescribed regions are influenced by an effective transmission value rather than discrete peak IL values. The 5 mm leaf system does not introduce increased IL and is an appropriate system for IMRT.

Humans↗

PubMed2006

A randomised, double-blind, placebo-controlled trial of a recombinant version of human alpha-fetoprotein (MM-093) in patients with active rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) tends to remit during pregnancy, with more patients achieving remission in the third trimester, coinciding with an increase in levels of alpha-fetoprotein (AFP). In vitro and animal studies have shown that AFP has immunomodulatory properties. MM-093 is a non-glycosylated, recombinant version of human AFP. OBJECTIVE: To assess the safety, tolerability and clinical effects of MM-093 during a 12-week, randomised, double-blind, placebo-controlled study. METHODS: 12 patients with RA, who had active disease and were on stable doses of methotrexate, received weekly subcutaneous injections of placebo or 21 mg of MM-093. Assessments were carried out at baseline and weekly thereafter. RESULTS: Baseline characteristics were similar in both groups. There was one dropout in the placebo group, due to flare of disease. Treatment with MM-093 was well tolerated. No serious adverse event was observed. By day 85, MM-093 produced a significant mean improvement from baseline in Disease Activity Score 28 (DAS28; 0.913 vs 0.008, p = 0.033) and patient's global assessment (28.9% vs -36.3%, p = 0.02) compared with placebo. CONCLUSION: This is the first randomised, controlled trial of MM-093, a recombinant version of human AFP, in patients with RA. MM-093 was well tolerated. Evidence of efficacy was observed, suggesting that MM-093 may have therapeutic potential in RA.

Arthritis, Rheumatoid↗

PubMed2000

Diagnosis of acute appendicitis: comparison of 5- and 10-mm CT sections in the same patient.

PURPOSE: To compare 5- and 10-mm computed tomographic (CT) sections in the same patient to diagnose acute appendicitis. MATERIALS AND METHODS: During an 11-month period, 100 consecutive patients clinically suspected to have acute appendicitis underwent abdominal and pelvic CT. Helical, 10-mm-collimated sections from the diaphragm to the pubic symphysis and 5-mm-collimated sections through the lower part of the abdomen and upper part of the pelvis were obtained. The 10- and 5-mm sections from each patient were separated into two groups and were interpreted independently by two abdominal imaging attending physicians who were blinded to the final results. The interpretations were correlated with the histopathologic or final clinical diagnoses. RESULTS: Data analysis from blinded reader interpretations of the 5- and 10-mm sections, respectively, revealed sensitivities of 99% and 82% (P <.001), specificities of 98% and 95% (P =.426), and accuracies of 99% and 89% (P <.001). Among the 48 cases of acute appendicitis, abnormal appendices were identified in 94% (n = 45) and 69% (n = 33) (P <.05) on 5- and 10-mm-collimated sections, respectively. Right-lower-quadrant inflammatory changes were identified in 98% (n = 47) and 71% (n = 34) (P <.05) on 5- and 10-mm-collimated sections, respectively. Normal appendices were identified in 75% (n = 39) and 52% (n = 27) of the 52 negative cases on 5- and 10-mm sections (P =.025), respectively. CONCLUSION: Use of thin-section CT significantly improves the diagnosis of acute appendicitis.

Acute Disease↗

PubMed2004

Possible roles for activating RAS mutations in the MGUS to MM transition and in the intramedullary to extramedullary transition in some plasma cell tumors.

To assess a possible role in tumor progression, the occurrence and type of K- and N-RAS mutations were determined in purified tumor cells, including samples from patients with premalignant monoclonal gammopathy of undetermined significance (MGUS), multiple myeloma (MM), and extramedullary plasma cell (PC) tumors (ExPCTs). Immunophenotypic aberrant PCs were flow sorted from 20 MGUS, 58 MM, and 13 ExPCT patients. One RAS mutation was identified in 20 MGUS tumors (5%), in contrast to a much higher prevalence of RAS mutations in all stages of MM (about 31%). Further, oncogene analyses showed that RAS mutations are not evenly distributed among different molecular subclasses of MM, with the prevalence being increased in MM-expressing cyclin D1 (P = .015) and decreased in MM with t(4;14) (P = .055). We conclude that RAS mutations often provide a genetic marker if not a causal event in the evolution of MGUS to MM. Surprisingly, RAS mutations were absent in bone marrow tumor cells from all patients with ExPCT, a result significantly different from intramedullary MM (P = .001). From 3 of 6 patients with paired intramedullary and extramedullary PCs and identical immunoglobulin heavy chain gene (IgH) sequences, RAS mutations were identified only in extramedullary PCs, suggesting a role for RAS mutations in the transition from intramedullary to extramedullary tumor.

Base Sequence↗

PubMed1996

Polyethylene wear in Scanhip arthroplasty with a 22 or 32 mm head: 62 matched patients followed for 7-9 years.

We measured radiographic polyethylene wear in patients with Scanhip arthroplasty and no clinical or radiographic signs of loosening. The patients were divided into 2 groups according to head sizes. 32 patients (33 hips) had an implant with a 22 mm and 30 patients (34 hips) with a 32 mm head. They were followed for 7-9 years. The groups were matched for diagnosis, sex, weight, age, and time of follow-up. The mean linear wear with a 22 mm head was 1.1 mm and with a 32 mm head 1.5 mm (p 0.004), which corresponds to a yearly wear rate of 0.15 mm and 0.18 mm, respectively. The mean difference in volumetric wear was greater, 420 mm3, as compared to 1239 mm3.

Adult↗

PubMed1983

Properties of MM 13902 and other carbapenem antibiotics in vitro and in vivo.

The carbapenem antibiotics, which include the olivanic acids and the thienamycins, have a broad-spectrum of antibacterial activity but only thienamycin itself shows appreciable activity against Pseudomonas aeruginosa. The zwitterionic nature of thienamycin was reproduced in the olivanic acid series by preparing the deacetyl derivatives of MM 17880 and MM 22380--compounds NA 26975 and NA 26978. The latter derivative showed antipseudomonas activity and had an antibacterial spectrum similar to thienamycin itself. In contrast the O-sulfated analogue, NA 26975, was no more active than the parent compound against P. aeruginosa. Both deacetyl compounds were more stable than the parent natural products to a mouse kidney enzyme preparation and gave higher urinary recoveries in the mouse. Pharmacokinetic studies with MM 13902 in various animal species showed that the compound was rapidly eliminated from the blood and gave only low urinary recoveries. Similar findings were observed also in human volunteers given MM 13902. The nephrotoxicity reported for thienamycin/MK 0787 in the rabbit was not seen with the olivanic acids MM 13902, MM 17880, MM 22382 and MM 22383 when tested under the same conditions.

Adolescent↗

PubMed2000

[Thoracoscopic pleural biopsy under local anesthesia using a 2 mm laparoscope].

Thoracoscopy is indicated in patients with undiagnosed effusion after conventional methods. It has been usually performed under general anesthesia or using a thoracoscope with a thoracoscope with a diameter over 5 mm. However, it is an invasive diagnostic technique. We evaluated the feasibility of thoracoscopic pleural biopsy under local anesthesia using a 2 mm laparoscope. Six patients with a pleural effusion of unknown etiology after conventional methods, underwent thoracoscopy under local anesthesia. A 2 mm laparoscope and biopsy forceps (2 mm Minisite, United States Surgical Corp., USA) was used in all patients. Pleural fluid was removed, and the thoracic cavity was inspected. Thoracoscopic intercostal blocks were performed with 1% lidocaine, and then a biopsy was performed. The biopsy specimen was sent for histopathology. Three patients were shown to have carcinomatous pleurisy, two of them with localized lesions less than 10 mm. In the remaining three patients, non-specific diagnoses were made, but long-term follow-up revealed no malignant pleural disease. Although the pictures obtained using a 2 mm laparoscope were inferior in quality, they were adequate for the detection of malignant lesions in the pleural cavity. There were no procedure-related complications. These findings suggest that thoracoscopy using a 2 mm laparoscope is (1) a useful diagnostic tool in cases of pleural malignancy; (2) a minimally invasive method with the advantage of being easily performed under local anesthesia. Thus, thoracoscopic pleural biopsy using a 2 mm laparoscope appears to be useful for undiagnosed pleural effusion.

Anesthesia, Local↗