Changes in the pleural cavity by pleurodesis using talc or OK-432: an experimental study.
ABSTRACT To define the changes in the pleural cavity after pleurodesis induced by talc or OK-432.
A total of 30 rats were divided into three groups: a normal saline group (control group, n = 10), a group administered 400 mg/kg talc (talc group, n = 10), and a group administered 0.3 KE/kg OK-432 (OK-432 group, n = 10). Pleural cavities were examined and scored on the 30th day after the intrapleural administration of each agent.
Both the talc group and OK-432 group showed significantly higher macroscopic or microscopic pleurodesis scores than the control group (P < 0.05). Upon microscopic evaluation, the pleurodesis scores in the talc group were significantly higher than those in the OK-432 group (P < 0.01).The majority of the pleural thickness was found on the visceral pleura, and the parietal pleura was very thin. The thickness of the visceral pleura in the talc group was significantly higher than that in the OK-432 group (P < 0.005). Pathologically, the pleural thickening in the talc group consisted of fibrous tissue with injury of the pleural mesothelium, and talc particles were seen in the submesothelial fibrotic tissue and inside the alveoli.
Talc pleurodesis induces more marked changes in the pleural cavity than OK-432-induced pleurodesis.
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ABSTRACT: INTRODUCTION: In patients with refractory pleural effusion or pneumothorax, fever and elevated level of white blood cell count (WBC) are frequently observed after chemical pleurodesis with intrapleural injection of OK-432, which make it difficult to differentiate whether it was from the side effects of OK-432 or concurrent bacterial infection. OBJECTIVE: Procalcitonin (PCT) levels were measured before and after pleurodesis so as to discuss whether PCT is useful for distinguishing between the side effects of OK-432 and concurrent bacterial infection. METHOD: 26 patients with refractory pleural effusion or pneumothorax who underwent chemical pleurodesis with intrapleural injection of OK-432 at the First Affiliated Hospital of Sun Yat-sen University between August 2010 and August 2012 were included in our study. Levels of PCT and WBC were measured before and after pleurodesis. RESULT: Of all 26 patients, 22 patients were with refractory pleural effusion and the other four were with pneumothorax. The median serum levels of PCT and WBC elevated from 0.155 to 1.470 ng/ml (p=0.009) and from 5.920 to 10.475 ×10(9) /L (p=0.000), respectively. No patient was given antibiotics and fever subsided. CONCLUSION: Intrapleural injection of OK-432 could increase the serum level of PCT and WBC with no bacterial infection. The serum PCT level may not be useful to distinguish whether fever was caused by the side effects of OK-432 or concurrent bacterial infection.The Clinical Respiratory Journal 05/2013; · 1.66 Impact Factor
Article: New agents for pleurodesis[Show abstract] [Hide abstract]
ABSTRACT: At times when patients have a malignant pleural effusion or a pneumothorax, one wishes to eliminate the pleural space by pleurodesis. This article describes results from attempting pleurodesis with silver nitrate, iodopovidone (betadine), transforming growth factor beta (TGFβ), OK432, and lipoteichoic acid-T. The two most promising agents seem to be silver nitrate and iodopovidone. Both agents induce pleurodesis that is at least comparable with that produced by talc, and neither induced the acute respiratory distress syndrome that sometimes occurs after intrapleural administration of talc.Current Respiratory Care Reports. 2(2).