The Experts below are selected from a list of 15972 Experts worldwide ranked by ideXlab platform
Gang Hou - One of the best experts on this subject based on the ideXlab platform.
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semi rigid thoracoscopic punch biopsy using a hybrid knife with a high pressure water jet for the diagnosis of Pleural effusions
Respiration, 2016Co-Authors: Yan Yin, Xiao-bo Wang, Ralf Eberhardt, Felix J.f. Herth, Jian Kang, Qiuyue Wang, Gang HouAbstract:Semi-rigid thoracoscopy is an important technique in the definitive diagnosis of Pleural diseases with high diagnostic sensitivity and specificity. Obtaining adequate samples from thickened Pleura is the most important limitation of semi-rigid thoracoscopy with a standard flexible forceps (SFF) compared with rigid thoracoscopy, especially in patients with mesothelioma or benign fibrothorax. Developing a convenient, efficient and safe biopsy technique to obtain sufficient samples from such patients is a key topic in semi-rigid thoracoscopy. The hybrid knife (HK) is an innovative design fusing high-pressure water injection and a conventional diathermic knife that can allow for the safe resection of a larger lesion during gastrointestinal endoscopic dissection. Here, we describe 3 patients with unexplained Pleural effusion who underwent Pleural biopsy using an HK to investigate the potential use of the HK as a new Pleural biopsy device in semi-rigid thoracoscopy when Pleural lesions are difficult to biopsy using an SFF. The biopsies were obtained successfully by HK, and the diagnosis followed. The sizes of the biopsies collected by HK are larger than those collected by SFF. No complications were observed. Electrocautery biopsy using an HK during semi-rigid thoracoscopy has great potential for diagnosing consistent abnormal Pleuras, which are difficult to biopsy with an SFF.
Gary D Kukes - One of the best experts on this subject based on the ideXlab platform.
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Pleural fluid transforming growth factor β1 correlates with Pleural fibrosis in experimental empyema
American Journal of Respiratory and Critical Care Medicine, 2003Co-Authors: Scott A Sasse, Martin R Jadus, Gary D KukesAbstract:Transforming growth factor–β1 (TGF-β1) is a growth factor that is implicated in fibrosis of many organs. The purpose of this study was to determine the sequential levels of TGF-β1 in the Pleural fluid of rabbits that had undergone empyema induction, as fibrosis of the Pleural space develops. Thirty-seven rabbits underwent empyema induction. Rabbits were sacrificed on Days 1, 2, 3, 4, 5, 6, and 8. Pleural fluid and viscera Pleura specimens were collected at autopsy. TGF-β1 levels were measured in Pleural fluid using a commercially available ELISA kit, and pathologic specimens were scored for evidence of fibrosis (Pleural thickness and number of fibroblasts). The median levels of Pleural fluid TGF-β1 increased from 8,100 pg/ml (Days 1 and 2) to 39,600 pg/ml (Day 8). Pleural fluid TGF-β1 levels closely correlated with microscopic Pleural thickness (r = 0.7, p < 0.001) and number of fibroblasts present in the visceral Pleura (r = 0.68, p < 0.001). The first increase in Pleural fluid levels of TGF-β1 (Day 3) o...
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Pleural fluid transforming growth factor β1 correlates with Pleural fibrosis in experimental empyema
American Journal of Respiratory and Critical Care Medicine, 2003Co-Authors: Scott A Sasse, Martin R Jadus, Gary D KukesAbstract:Transforming growth factor-beta1 (TGF-beta1) is a growth factor that is implicated in fibrosis of many organs. The purpose of this study was to determine the sequential levels of TGF-beta1 in the Pleural fluid of rabbits that had undergone empyema induction, as fibrosis of the Pleural space develops. Thirty-seven rabbits underwent empyema induction. Rabbits were sacrificed on Days 1, 2, 3, 4, 5, 6, and 8. Pleural fluid and viscera Pleura specimens were collected at autopsy. TGF-beta1 levels were measured in Pleural fluid using a commercially available ELISA kit, and pathologic specimens were scored for evidence of fibrosis (Pleural thickness and number of fibroblasts). The median levels of Pleural fluid TGF-beta1 increased from 8,100 pg/ml (Days 1 and 2) to 39,600 pg/ml (Day 8). Pleural fluid TGF-beta1 levels closely correlated with microscopic Pleural thickness (r = 0.7, p < 0.001) and number of fibroblasts present in the visceral Pleura (r = 0.68, p < 0.001). The first increase in Pleural fluid levels of TGF-beta1 (Day 3) occurred before the increase in Pleural thickness (Day 4) and before the increase in number of fibroblasts (Day 4). In conclusion, Pleural fluid levels of TGF-beta1 rise in experimental empyema as Pleural fibrosis develops. The rise in empyemic Pleural fluid TGF-beta1 levels correlates with markers of Pleural space fibrosis.
Hajime Takizawa - One of the best experts on this subject based on the ideXlab platform.
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a simple method for differentiating complicated parapneumonic effusion empyema from parapneumonic effusion using the split Pleura sign and the amount of Pleural effusion on thoracic ct
PLOS ONE, 2015Co-Authors: Naoki Tsujimoto, Richard W. Light, Takeshi Saraya, Yayoi Tsukahara, Takashi Koide, Daisuke Kurai, Haruyuki Ishii, Hirokazu Kimura, Hajime Goto, Hajime TakizawaAbstract:Background Pleural separation, the “split Pleura” sign, has been reported in patients with empyema. However, the diagnostic yield of the split Pleura sign for complicated parapneumonic effusion (CPPE)/empyema and its utility for differentiating CPPE/empyema from parapneumonic effusion (PPE) remains unclear. This differentiation is important because CPPE/empyema patients need thoracic drainage. In this regard, the aim of this study was to develop a simple method to distinguish CPPE/empyema from PPE using computed tomography (CT) focusing on the split Pleura sign, fluid attenuation values (HU: Hounsfield units), and amount of fluid collection measured on thoracic CT prior to diagnostic thoracentesis. Methods A total of 83 consecutive patients who underwent chest CT and were diagnosed with CPPE (n=18)/empyema (n=18) or PPE (n=47) based on the diagnostic thoracentesis were retrospectively analyzed. Results On univariate analysis, the split Pleura sign (odds ratio (OR), 12.1; p<0.001), total amount of Pleural effusion (≥30 mm) (OR, 6.13; p<0.001), HU value≥10 (OR, 5.94; p=0.001), and the presence of septum (OR, 6.43; p=0.018), atelectasis (OR, 6.83; p=0.002), or air (OR, 9.90; p=0.002) in Pleural fluid were significantly higher in the CPPE/empyema group than in the PPE group. On multivariate analysis, only the split Pleura sign (hazard ratio (HR), 6.70; 95% confidence interval (CI), 1.91-23.5; p=0.003) and total amount of Pleural effusion (≥30 mm) on thoracic CT (HR, 7.48; 95%CI, 1.76-31.8; p=0.006) were risk factors for empyema. Sensitivity, specificity, positive predictive value, and negative predictive value of the presence of both split Pleura sign and total amount of Pleural effusion (≥30 mm) on thoracic CT for CPPE/empyema were 79.4%, 80.9%, 75%, and 84.4%, respectively, with an area under the curve of 0.801 on receiver operating characteristic curve analysis. Conclusion This study showed a high diagnostic yield of the split Pleura sign and total amount of Pleural fluid (≥30 mm) on thoracic CT that is useful and simple for discriminating between CPPE/empyema and PPE prior to diagnostic thoracentesis.
Jeanfrancois Cordier - One of the best experts on this subject based on the ideXlab platform.
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syndrome of Pleural and retrosternal bridging fibrosis and retroperitoneal fibrosis in patients with asbestos exposure
Case Reports, 2009Co-Authors: Vincent Cottin, P Y Brillet, Francois Combarnous, Florence Duperron, Hilario Nunes, Jeanfrancois CordierAbstract:Two case histories are described of Pleural and anterior mediastinal fibrosis presenting as a continuous fibrotic process with thick parietal Pleural plaques extending from one Pleura to the contralateral Pleura through the retrosternal area, and with retroperitoneal fibrosis. Follow-up over 4 years in one case demonstrated rapid progression of disease, with Pleural fibrosis preceding retrosternal and retroperitoneal fibrosis. Histopathological analysis in both cases showed non-tumoral fibrosis with broad fibrous bundles surrounding fibroblasts (and lymphocytes in one case). Possible causes such as infections and exposure to ergot derivatives were excluded. Both patients had been slightly or moderately exposed to asbestos.
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syndrome of Pleural and retrosternal bridging fibrosis and retroperitoneal fibrosis in patients with asbestos exposure
Thorax, 2007Co-Authors: Vincent Cottin, P Y Brillet, Francois Combarnous, Florence Duperron, Hilario Nunes, Jeanfrancois CordierAbstract:Two case histories are described of Pleural and anterior mediastinal fibrosis presenting as a continuous fibrotic process with thick parietal Pleural plaques extending from one Pleura to the contralateral Pleura through the retrosternal area, and with retroperitoneal fibrosis. Follow-up over 4 years in one case demonstrated rapid progression of disease, with Pleural fibrosis preceding retrosternal and retroperitoneal fibrosis. Histopathological analysis in both cases showed non-tumoral fibrosis with broad fibrous bundles surrounding fibroblasts (and lymphocytes in one case). Possible causes such as infections and exposure to ergot derivatives were excluded. Both patients had been slightly or moderately exposed to asbestos. These cases represent an unusual new presentation of Pleural and retrosternal fibrosis extending beyond the anatomical structures and associated with retroperitoneal fibrosis.
Yan Yin - One of the best experts on this subject based on the ideXlab platform.
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semi rigid thoracoscopic punch biopsy using a hybrid knife with a high pressure water jet for the diagnosis of Pleural effusions
Respiration, 2016Co-Authors: Yan Yin, Xiao-bo Wang, Ralf Eberhardt, Felix J.f. Herth, Jian Kang, Qiuyue Wang, Gang HouAbstract:Semi-rigid thoracoscopy is an important technique in the definitive diagnosis of Pleural diseases with high diagnostic sensitivity and specificity. Obtaining adequate samples from thickened Pleura is the most important limitation of semi-rigid thoracoscopy with a standard flexible forceps (SFF) compared with rigid thoracoscopy, especially in patients with mesothelioma or benign fibrothorax. Developing a convenient, efficient and safe biopsy technique to obtain sufficient samples from such patients is a key topic in semi-rigid thoracoscopy. The hybrid knife (HK) is an innovative design fusing high-pressure water injection and a conventional diathermic knife that can allow for the safe resection of a larger lesion during gastrointestinal endoscopic dissection. Here, we describe 3 patients with unexplained Pleural effusion who underwent Pleural biopsy using an HK to investigate the potential use of the HK as a new Pleural biopsy device in semi-rigid thoracoscopy when Pleural lesions are difficult to biopsy using an SFF. The biopsies were obtained successfully by HK, and the diagnosis followed. The sizes of the biopsies collected by HK are larger than those collected by SFF. No complications were observed. Electrocautery biopsy using an HK during semi-rigid thoracoscopy has great potential for diagnosing consistent abnormal Pleuras, which are difficult to biopsy with an SFF.
