• Title/Summary/Keyword: Effusion

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Cytologic Analysis of Malignant Effusion (악성 체강삼출액의 세포학적 분석)

  • Kim, Sang-Pyo;Bae, Ji-Yeon;Park, Kwan-Kyu;Kwon, Kun-Young;Lee, Sang-Sook;Chang, Eun-Sook;Kim, Chung-Sook
    • The Korean Journal of Cytopathology
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    • v.6 no.2
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    • pp.116-124
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    • 1995
  • Eighty cases of malignant effusion were cytologically studied to elucidate the incidence of primary tumor site and cytologic characteristics of each tumor types. Eighty fluid specimens were composed of 43 ascitic, 35 pleural, and 2 pericardial effusion and primary tumor site had been confirmed by histology. The frequent primary sites were stomach(22 cases, 28%), lung(21 cases, 26%), ovary(11 cases, 14%), liver(7 cases, 9%), and breast (4 cases, 5%). The principal malignant tumors were adenocarcinoma (56 cases, 70%), squamous cell carcinoma (7 cases, 9%), liver cell carcinoma (7 cases, 9%), small cell carcinoma (4 cases, 5%), and non-Hodgkin's lymphoma (4 cases, 5%). The distinctive cytologic findings according to primary tumor types were as follows; the gastric adenocarcinomas were mainly characterized by isolated cells and irregular clusters sometimes with signet ring cells. Papillary serous cystadenocarcinoma of ovary showed frequently papillary clusters and occasional psammoma bodies. Breast carcinoma of ductal type showed cell balls with smooth margins. Colonic adenocarcinoma showed rather irregular clusters or palisading pattern of cylindrical cells. Metastatic squamous cell carcinoma, liver cell carcinoma, small cell carcinoma, and non-Hodgkln's lymphoma showed also characteristic features. These findings Indicate that the cytological features observed in the great majority of malignant effusion are similar to those of primary tumor types, which are very helpful to indentify the primary tumor site.

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Effect of Inclined Jet on Heat/Mass Transfer for Impingement/Effusion Cooling System (경사제트에 따른 충돌제트/유출냉각에서 열/물질전달 특성)

  • Hong, Sung-Kook;Rhee, Dong-Ho;Cho, Hyung-Hee
    • Transactions of the Korean Society of Mechanical Engineers B
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    • v.32 no.4
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    • pp.283-289
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    • 2008
  • An experimental investigation was conducted to investigate the heat/mass transfer for impingement/effusion cooling system with inclined jet. Jets with inclined angle of 60 are applied to impingement/effusion cooling. At the jet Reynolds number of 10,000, the experiments were carried out for blowing ratios ranging from 0.0 to 1.5. The local heat/mass transfer coefficients on the effusion plate are measured using a naphthalene sublimation method. The result indicates that the inclined jet causes the non-uniform and low heat/mass transfer compared to the vertical jet. At stagnation region, the peak position is shifted from the geometrical center of injection hole due to Coanda effect and its level is higher than that of vertical jet due to increase in turbulence intensity by steep velocity gradient near the stagnation region. Further, the secondary peak region disappears because the interaction between adjacent wall jets weakens. When the initial crossflow occurs, the distorted heat/mass transfer pattern appears. As the blowing ratio (crossflow rate) increases, the heat/mass transfer distributions become similar to those of the vertical jet. This is because the effect of crossflow is dominant compared to that of inclined jet under high blowing ratio $(M{\geq}1.0)$. At low blowing ratio $(M{\leq}0.5)$, averaged Sh value is 10% lower than that of vertical jet, whereas its value at high blowing ratio $(M{\geq}1.0)$ is similar to that of vertical jet.

Progression of Subdural Effusion after Surgical Treatment (뇌경막하수종의 수술적 치료에 따른 임상 경과)

  • Kim, Jaehyeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.4
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    • pp.1765-1773
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    • 2013
  • The purpose of this study was to contribute to the medical treatment of subdural effusion through clinical sequence analysis of patients who experienced improvement of subdural drainage and had a second operation for subdural drainage or subduroperitoneal shunt. Sixteen cases of the whole patients who have been underwent subdural effusion and subdural drainage were analyzed during the period from 2006 July to 2012 June. The study gave us a result that all of patients, who was taking aspirin, have been under the second operation(p<0.001) and these group have had a subduraoperitoneal shunt(p=0.014)). According to the comparative analysis for the patients group that divided into two; one had subduroperitoneal shunt and the other had no subduroperitoneal shunt, the outcomes of this study were shown as follows. First, their median line deviation was serious in their brain CT. In addition, their subdural effusion increased or did not change with a headache, vomiting, fever and dyspnea. As a result of those symptoms. subduraoperitoneal shunt was carried out(p=0.006). The surgical method for patients who were taken asprin must be cautiously selected and the prevention of sudden disappearance of cerebrospinal fluid and excessive change of intracranial pressure is very important in operation craniectomy.

Successful pleurodesis with OK-432 in preterm infants with persistent pleural effusion

  • Kim, Jeong-Eun;Lee, Chul;Park, Kook-In;Park, Min-Soo;NamGung, Ran;Park, In-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.5
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    • pp.177-180
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    • 2012
  • OK-432 (picibanil) is an inactivated preparation of $Streptococcus$ pyogenes that causes pleurodesis by inducing a strong inflammatory response. Intrapleural instillation of OK-432 has recently been used to successfully treat neonatal and fetal chylothorax. Here we report a trial of intrapleural instillation of OK-432 in two preterm infants who were born with hydrops fetalis and massive bilateral pleural effusion. Both cases showed persistent pleural effusion, refractory to conservative treatment, up to postnatal days 26 and 46, respectively. An average of 80 to 140 mL of pleural fluid was drained daily. In case 1, the infant was treated with OK-432 during the fetal period at gestation 28 weeks and 4 days of gestation, but showed recurrence of pleural effusion and progressed into hydrops. Within two to three days after OK-432 injection, the amount of pleural fluid drainage was dramatically decreased and there was no reaccumulation. We did not observe any side effects related to OK-432 injection. We suggest that OK-432 should be considered as a therapeutic option in infants who have persistent pleural effusion for more than four weeks, with the expectation of the early removal of the chest tube and a good outcome.

A Case of Pleural Effusion after Malposition of Central Venous Catheter (중심정맥카테터 삽입의 이상위치로 발생한 편측성 흉수 1례)

  • Kim, Jae Seok;Kim, Sang-Ha;Lee, Nak Won;Kwon, Woo Cheol;Choi, Hun;Beon, Jong Won;Hong, Tae Won;Shin, Kye Chul;Yong, Suk Joong
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.690-693
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    • 2006
  • Central venous catheterization is used to provide a large amount of fluid, total parenteral nutrition and to administer antitumor agents with few complications reported. We report an uncommon case of pleural effusion that occurred after central venous catheterization. In many cases, the mechanism for the pleural effusion after central venous catheterization occurs through an injury to the superior vena cava by the continuous mechanical force of the catheter tip, the flow of large amount of fluid and an osmotic injury to the wall of the vein. This case is somewhat different in that the central catheter was placed in an aberrant vessel resulting in the pleural effusion. A post-placement chest roentgenogram and the correct approach of catheterization are important for preventing this complication.

Two Cases of Benign Solitary Schwannoma with Pleural Effusion (흉수를 동반한 양성 고립자 신경초종 2예)

  • Cho, Jin-Hoon;Kim, Ki Uk;Park, Hye-Kyung;Jeong, Yeon Joo;Kim, Young Dae;Kim, Yun Seong;Lee, Min Ki;Park, Soon Kew
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.1
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    • pp.78-82
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    • 2007
  • Schwannoma represents approximately 40% of neurogenic tumors arising in the mediastinum, and develops along the sympathetic or parasympathetic chain, intercostals nerve, and spinal ganglia. It is usually asymptomatic, and is confronted accidentally but can produce chest pain, cough and dyspnea. However, dyspnea with pleural effusion is rare in patients with benign schwannoma. We encountered two cases of benign schwannoma with pleural effusion. Both cases had similar initial symptoms and the characteristics of a mass but the characteristics of pleural effusion analysis were different. The benign schwannoma was confirmed in two cases using VATS (video-assisted tharawswpic surgery).

Pleural Space Elastance and Its Relation to Success Rates of Pleurodesis in Malignant Pleural Effusion

  • Masoud, Hossam Hosny;El-Zorkany, Mahmoud Mohamed;Ahmed, Azza Anwar;Assal, Hebatallah Hany
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.1
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    • pp.67-73
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    • 2021
  • Background: Pleurodesis fails in 10%-40% of patients with recurrent malignant pleural effusions malignant pleural effusion and dyspnea. This study aimed to assess the values of pleural elastance (PEL) after the aspiration of 500 mL of pleural fluid and their relation to the pleurodesis outcome, and to compare the pleurodesis outcome with the chemical characteristics of pleural fluid. Methods: A prospective study was conducted in Kasr El-Aini Hospital, Cairo University, during the period from March 2019 to January 2020. The study population consisted of 40 patients with malignant pleural effusion. The measurement of PEL after the aspiration of 500 mL of fluid was done with "PEL 0.5" (cm H2O/L), and the characteristics of the pleural fluid were chemically and cytologically analyzed. Pleurodesis was done and the patients were evaluated one month later. The PEL values were compared with pleurodesis outcomes. Results: After 4-week of follow-up, the success rate of pleurodesis was 65%. The PEL 0.5 was significantly higher in failed pleurodesis than it was in successful pleurodesis. A cutoff point of PEL 0.5 >14.5 cm H2O/L was associated with pleurodesis failure with a sensitivity and specificity of 93% and 100%, respectively. The patients with failed pleurodesis had significantly lower pH levels in fluid than those in the successful group (p<0.001). Conclusion: PEL measurement was a significant predictor in differentiating between failed and successful pleurodesis. The increase in acidity of the malignant pleural fluid can be used as a predictor for pleurodesis failure in patients with malignant pleural effusion.

Which is the More Effective Option for Pleurodesis to Prevent the Recurrence of Malignant Pleural Effusion? Large-Particle Talc or Mistletoe Extract (ABNOVA Viscum Injection)

  • Changsung Han;Jonggeun Lee;Jeong Su Cho;Hyo Yeong Ahn
    • Journal of Chest Surgery
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    • v.56 no.5
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    • pp.353-358
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    • 2023
  • Background: Malignant pleural effusion affects many patients with advanced cancer. When chemotherapy or radiotherapy fails to relieve malignant pleural effusion and related symptoms, drainage and pleurodesis can help. Although surgical talc pleurodesis is the most widely used method, Viscum album, which has been recently used in surgical or bedside procedures, has demonstrated significant results and is as effective as talc. This study aimed to determine the most effective agent and procedure. Methods: Between January 2015 and July 2022, chemical pleurodesis was performed in 137 patients with malignant pleural effusion, using a V. album surgical procedure in 48, a V. album bedside procedure in 55, and a talc surgical procedure in 34 patients. We reviewed patients' clinical responses and disease progression after chemical pleurodesis. Results: The success rate was not significantly different among the V. album surgical procedures (91.7%), V. album bedside procedures (83.6%), and talc surgical procedures (91.2%). However, the total drainage amount and tube insertion duration in both Viscum groups were more effective than those in the talc group. Furthermore, the bedside Viscum group showed significantly lower post-pleurodesis pain scores than the other 2 groups. Conclusion: According to our results, talc and V. album can be considered ideal agents for chemical pleurodesis. However, Viscum pleurodesis showed safer outcomes in terms of ensuring quality of life than talc. Additionally, the bedside Viscum group showed significantly lower pain scores than the other groups. Hence, patients for whom surgical procedures are inappropriate can undergo bedside Viscum pleurodesis without diminishing the therapeutic effect.

Ante-Mortem Diagnosis of an Atypical Mixed Form of Feline Infectious Peritonitis through Pericardial Effusion Analysis in a Cat

  • Junyoung Kim;Yebeen Kim;Jihye Choi;Junghee Yoon
    • Journal of Veterinary Clinics
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    • v.40 no.4
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    • pp.308-313
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    • 2023
  • A 1-year-old castrated male Korean Shorthair cat presented with dyspnea, anorexia, lethargy, and seizures. Physical examination revealed salivation, right forelimb hemiparesis, and rapid breathing. No abnormalities were detected on auscultation. Laboratory findings revealed increased levels of bilirubin, aspartate aminotransferase (AST), globulin, glucose, and a decreased albumin-to-globulin (A:G) ratio. Both N-terminal pro-B-type natriuretic peptide (NT-proBNP) and feline serum amyloid A (fSAA) levels were significantly elevated. Thoracic radiography revealed mild cardiomegaly and diffuse increased interstitial infiltration with soft tissue opacity in the periphery of the right caudal pleural space. Echocardiography and lung ultrasonography were performed to investigate the cause of mild cardiomegaly and soft tissue opacity in the pleural space. Echocardiography revealed a mild amount of echogenic pericardial effusion, and lung ultrasonography showed an echogenic soft tissue mass with no blood signal in the right caudal pleural space, suggestive of a granulomatous lesion. After obtaining 5 mL of pericardial fluid through pericardiocentesis, cytology of the pericardial effusion sample revealed marked neutrophils and macrophages with no bacteria. IDEXX feline infectious peritonitis (FIP) virus real-time reverse transcriptase polymerase chain reaction (RT-PCR) confirmed the presence of the FIP virus biotype in the sample. This case presents a rarely reported atypical mixed form of FIP in a cat diagnosed ante-mortem using pericardial effusion analysis. In this case, ultrasound examination played a crucial role in the definitive diagnosis of FIP by PCR biotyping through pericardiocentesis. Ultrasonography can be highly beneficial in guiding the diagnosis and evaluation of cats with suspected FIP.

A Rare Case of Canine Pericardial Malignant Mesothelioma: Clinicopathologic Findings, Diagnostic Investigations, and Clinical Course with Epirubicin Treatment

  • Jun-Hyuk Min;Jiwoong Yoon;Sooyoung Son;Woo-Jin Song;Siheon Lee;Youngmin Yun;Hyunjung Park;Jongtae Cheong;Alba Maria M. Shank;Myung-Chul Kim
    • Journal of Veterinary Clinics
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    • v.41 no.3
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    • pp.170-177
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    • 2024
  • An adult male dog was presented for hemorrhagic pericardial effusion. Echocardiography and computed tomography revealed nodule-like lesions on the pericardium. Cytology of pericardial effusion and excisional pericardial lesions indicated neoplastic effusion. Histopathology indicated an inflamed neoplasm with a primary differential diagnosis of hemangiosarcoma and malignant mesothelioma (MM). Immunohistochemistry showed that atypical cells were positive for cytokeratin and vimentin, but negative for CD31, strongly favoring pericardial MM. Postoperative NT-proBNP level remained increased, which led to the administration of epirubicin to minimize potential cardiotoxicity. During the 4 cycles of epirubicin treatment, a total cumulative dose of 108 mg/m2 was administrated and no effusion recurrence was observed. After a month post-completion of chemotherapy, however, pleural effusion was detected with cardiac masses. The owner requested no further diagnostic investigations and chemotherapy. Due to deteriorating conditions, the dog died 132 days after the first presentation. Our case is the first notable attempt to treat canine malignant mesothelioma with epirubicin, providing the clinicopathologic, diagnostic routine, and clinical course of the affected dog.