Archive for the ‘Pleural Metastatic Carcinoma’ Category


Survival Time of Patients with Pleural Metastatic Carcinoma Predicted by Glucose and pH Studies: ConclusionsThe data represented in Figure 4 (the mortality rate of 67 percent experienced by group 1 during the first month was not reached by group 2 until the 15th month) when taken alone are quite explicit and indicate that when both mechanisms are affected (pleural glucose input and H + output), the development of a neoplasm is undoubtedly very advanced.
This theory has been confirmed in our work by the very close relationship that was found between the spread of the pleural lesions studied by thoracoscopy and the pH (p<0.0001) and low glucose values (p<0.05). (more…)

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  • According to what has been published, chiefly by the group of Sahn et al, the mechanisms that are able to bring about a fall in pleural fluid glucose and pH levels are intimately related since glucose metabolism does generate intrapleural acids.
    Good et al have shown that the principal pathogenesis of low glucose malignant eflusions is a blockage of the pleural passageways utilized by metabolic substances. This, therefore, would account for the relationship we found between low glucose levels and pleural lesions (p<0.05) and between these lesions and pleural fluid pH (p<0.0001). (more…)

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  • Survival Time of Patients with Pleural Metastatic Carcinoma Predicted by Glucose and pH Studies: Ratings of pleural lesionsThe mean ratings of pleural lesions and the survival times of each one of the groups, as well as the significant statistical differences are shown in Table 2. All of the survival time differences were significant (p<0.03), with the exception of group 2. This group had pH levels lower/higher than 7.30 and will be discussed later on. Also, we have introduced two groups into Table 2 which have not been previously mentioned. These groups are characterized by pH values lower/ higher than 7.35, and their differences are clearly more significant than the group with pH levels lower/ higher than 7.30 as far as pleural lesions and survival times are concerned. (more…)

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  • From January 1982 until May 1987, we diagnosed 50 cases of metastatic carcinoma of the pleura by thoracoscopy. The origins and histologic types of these malignancies are displayed in Table 1. We wish to point out that although metastatic neoplasms which originated in the lungs only made up 34 percent of the cases, they accounted for 50 percent of the group with low pleural glucose and/or pH levels. (more…)

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  • Survival Time of Patients with Pleural Metastatic Carcinoma Predicted by Glucose and pH Studies: Qualified the lesionsWe qualified the lesions found in a given pleural surface as “diffuse” when they were disseminated in this pleural layer. Those lesions became as “massive” when no normal pleural zones were macroscopically observed between the scattered lesions. This classification established which pleural surface was most affected, and in fact in the majority of cases, the spread of lesions found in different pleural zones was uneven. (more…)

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  • At our hospital in 1982, we initiated the policy of carrying out prospective studies of every patient who was to undergo thoracoscopy due to the presence of pleural effusion. On the same day as the exploration or, at the most, on the previous day, the cytology, cell count, total protein, glucose level and lactate dehydrogenase (LDH) of the pleural fluid, as well as both the arterial and pleural gas tensions were determined. In addition, the following systematic blood analyses were carried out: hemogram; ionogram; proteino-gram; glucose concentration in a fasting state; and liver enzyme. (more…)

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  • Survival Time of Patients with Pleural Metastatic Carcinoma Predicted by Glucose and pH StudiesThe relationship between pleural glucose levels and neoplastic effusions was first studied by Clarkson in 1964. This author associated low glucose concentrations in pleural fluid (less than 60 mg/dl) with the findings of numerous malignant cells and large effusion volumes. Some years later, Berger and Maher came to the conclusion that large effusion volumes themselves were responsible for the fall in glucose levels in pleural fluid. In recent years, it has been considered that pH and glucose are closely related when their values descend in pleural fluid, and the fact has been established that acid generation in the pleural cavity is originated by the metabolism of glucose. According to Good et al, pH levels drop when H+ ions are unable to leave the pleural cavity since their escape routes are blocked by a neoplasm or an acute inflammation of the pleural layers. in detail (more…)

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