Interventional management of recurrent malignant pleural effusion: state of the art in 2021.

OBJECTIVE: This narrative review aims to describe and compare different interventional methods for the management of recurrent malignant pleural effusion and offers perspectives for the future era. BACKGROUND: Dyspnea as a result of the recurrent malignant pleural effusion is one of the main factors decreasing the quality of life in patients with oncologic diseases. To date, there is no strict guideline for the management of malignant pleural effusions. RESULTS: Several different techniques are available to prevent production of the effusion or to provide intermittent drainage, however, the principle of these methods remains palliative. The choice of treatment in any patient depends mainly on the preferences of the patient, speed of the fluid production, expandability of the lung, and predicted survival of the patients. The interventional methods of managing malignant pleural effusions are described in detail, including thoracocentesis, chemical pleurodesis, talc poudrage pleurodesis, slurry pleurodesis, thoracoscopic procedures, indwelling pleural catheters, implantable pleural ports, and pleuroperitoneal shunting. CONCLUSION: Pleurodesis and fully implantable devices such as pleural ports may become the most useful techniques in the future, mainly because of better comfort for the patients and no need for repeated pleural punctures (Ref. 55).

Bronchoscopy in the Czech Republic in the past 45 years and the state in 2020.

BACKGROUND AND METHOD: To determine the current situation and trends in bronchology in the Czech Republic (CR), a questionnaire survey has been conducted by the Czech Pneumological and Phthisiological Society (CPFS). RESULTS: In 2020, 158 bronchoscopists conducted 26,700 BRS procedures, 927 of them were rigid. 2,869 procedures were done under general anaesthesia. Of diagnostic methods, the use of endobronchial ultrasound (EBUS) is rising, being available in 35 % BRS facilities in 2020. Interventional bronchology procedures are conducted in 17 facilities and 1,517 were executed in 2020. The numbers of cryocauterizations and stenting are growing. In the questionnaire we asked also about biomarkers of lung carcinoma that are examined at 47 out of 49 facilities. Since 1975 when 11,194 bronchoscopies were conducted in the CR, their numbers increased to 33,282 in 2009, then dropping slightly to 26,700 in 2020. At present, 254 bronchoscopies are conducted per 100,000 inhabitants in a year. CONCLUSIONS: Based on the BRS survey in 2020 it can be concluded that Czech bronchology is developing in the right direction and is well equipped with both, staff and technical devices. We are adopting new methods without delays and we expand the use of those working well (EBUS) (Tab. 4, Ref. 13).

Successful treatment of ventilator dependent emphysema with Chartis treatment planning and endobronchial valves.

INTRODUCTION: Emphysema is a leading cause of disability and death. Patients who require ventilator support as a result of respiratory failure have limited treatment options. We report a successful outcome for a ventilator dependent patient in whom endobronchial valves were inserted into lobes assessed as being without collateral ventilation. PRESENTATION OF CASE: A 54 year old male patient had been ventilator dependent for two months due to respiratory insufficiency from emphysema. Prior to admission, FEV(1) was 0.89L (25% predicted) and RV was 4.5L (205% predicted). CT scan showed destruction of right lower and middle lobes and left lower lobe. Chartis assessment showed the absence of collateral ventilation. Zephyr endobronchial valves were placed in left and right lower lobes. Lung volume reduction bilaterally was confirmed on chest X-ray and CT scan the following day. On day three, ventilator support was discontinued and there was no requirement for supplementary oxygen. At 30 days post procedure, the RV reduced to 3.2L (142% predicted) and the FEV(1) increased to 1.32L (38% predicted). DISCUSSION: Hyperinflation in emphysema compromises lung function. For this ventilator dependent patient, there were no other treatment options. Endoscopic lung volume reduction was successfully achieved by bilateral lower lobe placement of Zephyr endobronchial valves with a prior assessment using Chartis to determine the absence of collateral flow in the targeted lobes. The patient achieved an impressive 48% improvement in FEV(1) and a 29% reduction in RV. CONCLUSION: Endoscopic lung volume reduction assisted by Chartis to plan treatment resulted in a clinical and a health-economic benefit.

[Lung resection for a non-small cell carcinoma (stage IV) with a permanent intracavitary brachytherapy 125I]. / Resekce plic pro nemalobunecný karcinom (stadium IV) s permanentní intrakavitární brachyterapií 125I.

In November 2005, the authors used the lung resection method in combination with peroperative brachytherapy125 for a non-small cell carcinoma, for the first time. The patient had an adenocarcinoma of the right lung T2N2M0, stage IIIA. During the procedure, the team diagnosed advanced stage of the process, the tumor originated in the hilus region of the middle lobe with a metastatic spread into the superior and inferior lobe. Distant unilateral lymphonodes were infiltrated simultaneously. The histological examination confirmed the diagnosis of T2N2M1, however, the original classification was re-assessed and changed to stage IV. Pneumonectomy with lymphadenectomy of all of the macroscopically detectable lymphonodes was completed. The lymphatic drainage sites in the upper and lower mediastinum were covered by seeds of a permanent gama emitter 125I with a total dose of 100 Gy. The patient recovered with no complications and was discharged on the day 8. He was included in the study and will be followed on a regular basis. On the authors' opinion, the method of the lung resection with peroperative permanent brachytherapy has a potential for decreasing the tumor relaps rates, eventually, for improving the patients survival rates and their quality of life. The authors will continue their applied research of this serious problematics, aiming to confirm or refuse the stated hypothesis.

Preparation of nanoparticles by electrocoagulation from soluble exopolysaccharide produced by Claviceps viridis.

Electrocoagulation is an evolving technology that has been effectively applied for wastewater treatment but its applications in biotechnology and nanotechnology are very limited. This method was applied for the preparation of nanoparticles from soluble exopolysaccharide (EPS) produced by Claviceps viridis in a submerged batch culture. A cathode/anode pair electrode (Al or Fe) system was used for determination of the separation rates of electrocoagulation and the yields of EPS nanoparticles production. The separation rates of 0.170 +/- 0.003 mg EPS/sec (Fe electrodes) and 0.250 +/- 0.003 mg EPS/sec (Al electrodes) were calculated for voltage gradient 1 V/1 cm of electrodes distance and were constant during experiments. The specific yield of EPS nanoparticles production based on the consumed electric power was dependent on the material of the electrodes and its value was determined as 0.71 +/- 0.01 mg EPS/W for Fe electrodes and 0.91 +/- 0.01 mg EPS/W for Al electrodes, respectively.

Physiological dendrogram of Claviceps spp. based on sucrose metabolism in submerged cultures and its comparison with phylogenetic tree.

Sixteen isolates of Claviceps spp. were analyzed for the production of polysaccharides, oligosaccharides, and sucrose metabolism under conditions of submerged fermentation. Physiological markers calculated by the Verhulst-Pearl law were used for hierarchical cluster analysis. Low correlation was found between physiologically based dendrogram and phylogenetic analysis constructed from an alignment of rDNA sequences. To confirm the intraspecific uniformity of physiological markers three isolates of C. africana from different hosts and locations were included. The influence of genotype, physiological variability, environmental location and habitat on metabolite production is discussed.

Biodegradable plastics from renewable sources.

Plastic waste disposal is a huge ecotechnological problem and one of the approaches to solving this problem is the development of biodegradable plastics. This review summarizes data on their use, biodegradability, commercial reliability and production from renewable resources. Some commercially successful biodegradable plastics are based on chemical synthesis (i.e. polyglycolic acid, polylactic acid, polycaprolactone, and polyvinyl alcohol). Others are products of microbial fermentations (i.e. polyesters and neutral polysaccharides) or are prepared from chemically modified natural products (e.g., starch, cellulose, chitin or soy protein).

Long-term fertilization affects the abundance of saprotrophic microfungi degrading resistant forms of soil organic matter.

The effect of mineral and organic fertilization on the occurrence of soil microorganisms was determined in a field experiment. The colony-forming unit counts of saprotrophic microfungi, when estimated on a silicate gel medium containing fulvic acid as a sole carbon source, increased significantly with increasing doses of mineral and organic fertilization. Partial correlation analysis indicated that, unlike bacteria and actinomycetes, microfungi utilizing fulvic acid were significantly associated with soil organic carbon. No significant effects on bacteria and microfungi counted on common microbiological media were observed but counts of actinomycetes increased in a manured soil extensively fertilized by a mineral fertilizer. Fulvic acid utilizing microfungi, which are associated with areas rich in organics, play possibly the main role in mineralization of resistant forms of soil organic matter.

Kinetics of soluble glucan production by Claviceps viridis.

Among 18 tested strains of Claviceps spp., 7 produced significant amounts of exocellular polysaccharide (EPS). The maximum production of EPS was found in fermentation broth of Claviceps viridis. The kinetics of growth, substrate consumption, and EPS production in the batch, aerobic, submerged culture of this fungus were investigated in detail. The experimental data were processed by a simple mathematical model describing mass balance of growth, substrate consumption, formation of intermediates, and production of EPS. The parameters of the model were estimated from data obtained in cultivation performed in flasks and two laboratory fermentors of different size. Physiological similarity was obtained during process scale-up in volumetric ratio 1:100. The sugar consumption efficiency (52%) and observed EPS productivity (1.9 kg/m3 per d) were comparable with literature data.

Identification of Streptomyces odor spectrum.

The chemical composition of odors produced by nine strains of Streptomyces was determined. Strains Streptomyces aureofaciens, S. avermitilis, S. cinamomensis, S. coelicolor, S. griseus, S. lividans, S. rimosus, S. spectabilis, S. virginiae (as representatives of producers of biologically active compounds) were cultivated at the same time statically in dishes and in shaken flasks at similar cultivation conditions. According to the GC-MS analysis of odor compounds, more than twenty noteworthy volatile chemical individuals were identified. As the main component of odor spectrum geosmin and homologues of oxolones (dihydrofuranones) were found; the other compounds (pyrazine derivatives, acetoin and its homologues, aromatic esters, furan derivatives, etc.) were in minority.

Organic fertilization changes the response of mycelium of arbuscular mycorrhizal fungi and their sporulation to mineral NPK supply.

The synergetic effect of organic (cow manure) and mineral fertilization on the development arbuscular mycorrhizal (AM) fungi was demonstrated. The length of AM mycelium and sporulation were used as sensitive markers of the physiological state of soil AM fungal population. In manured treatments, both parameters increased in proportion with increasing mineral fertilization. In unmanured soil, the opposite trend was observed for the length of AM hyphae, which decreased with increasing mineral fertilization. Correlation analysis showed the dependence of length of AM hyphae and sporulation on soil available phosphorus. The correlation was negative in soil with no mineral fertilization and positive in soil supplied with luxury doses of mineral fertilizer.

Chromatography of long chain alcohols (polyprenols) from animal and plant sources.

This paper provides a comprehensive overview of existing chromatographic methods for the analysis of long chain alcohols (polyprenols) from animal and plant sources. After a brief introductory discussion on the biological aspects of the polyprenols, the review focuses on various techniques for the isolation, purification, chromatographic separation and detection of polyprenols.

[Chemoprevention of bronchogenic carcinoma]. / Chemoprevence bronchogenního karcinomu.

Lung cancer is the leading cause of cancer-related deaths in many developed countries. Understanding its carcinogenesis is critical for the development of rational approaches to cancer prevention. The concept of chemoprevention is based on the idea that the diffuse injury of the respiratory epithelium results from chronic carcinogen exposure. Chemoprevention agents should reverse or suppress the development of premalignant and malignant changes by different mechanisms. In the future, the clinical application to risk groups of patients could lead to substantially decreased frequency of the lung cancer. The results of ongoing trials are eagerly awaited.

In vivo and In vitro function of the intracellular proteolytic apparatus in nongrowing bacillus megaterium under heat stress

In Bacillus megaterium sporulating at 35 degreesC, up to 90% of 10-min pulse-labeled proteins were degraded. Degradation proceeded in two waves. Short-lived proteins, i.e., intrinsically labile proteins and proteins made short-lived because of starvation, were mostly degraded during the reversible sporulation phase. Their amount corresponded to 20% or slightly more during 2 h. The second wave of protein degradation, which followed during the irreversible sporulation phase at 35 degreesC, increased the amount of total degradable pulse-labeled proteins to about 90%. This wave was absent in the isogenic asporogenic mutant 27-36 or in the wild strain, whose sporulation was inhibited by increased temperature. The proportion of degradable proteins was thus reduced to less than 40% in the asporogenic mutant incubated at 35 degreesC and to 46% in the wild strain whose sporulation was suppressed by the temperature of 47 degreesC. Unlike sporulating cells, these cells were thus capable of degrading short-lived and denatured proteins, but were not able to degrade most of other proteins. The in vitro protein degradation was substantially enhanced by increasing the Ca2+ concentration, suggesting a role of Ca2+-dependent proteinase(s) in the process.

7Beta-OH-DHEA counteracts dexamethasone induced suppression of primary immune response in murine spleenocytes.

The effect of dexamethasone and of three potential antiglucocorticoids, namely dehydroepiandrosterone (DHEA) and its 7alpha-and 7beta-hydroxylated metabolites, on primary immune response has been studied by measuring the number of plaque forming cells (NPFC) and their viability in a cell culture of murine spleenocytes. As expected, dexamethasone suppressed considerably the NPFC as well as their viability. Surprisingly, DHEA as well as its 7alpha-hydroxylated metabolite decreased significantly the NPFC, while the effect of 7beta-hydroxy-DHEA was different: at low doses it decreased the NPFC, but this effect was less pronounced at higher concentrations. In addition, 7beta-hydroxy-DHEA was able to counteract the effect of dexamethasone on the NPFC. None of the natural steroids affected the cell viability.

Effect of protein kinase inhibitors on primary antibody induction in tissue cultures.

The effects of protein-kinase-inhibitors (PKIs) on protein kinase C (PKCs) i.e., staurosporin, calphostin C, H-7, H-8, H-9, on phosphatidyl inositol 3-proteinkinase (PI3-K) i.e., wortmannin, and on protein tyrosine kinase (PTKs) i.e., genistein, herbimycin A, sanguinarin, lavendustin A and B were tested on the induction phase of the primary Ab-response in vitro. The inhibitory action of PKIs was the highest with herbimycin A, sanguinarin, H-9 and wortmannin. Although wortmannin inhibits the function of T-lymphocytes (Taub et al., 1997, Shi et al., 1997), we believe that this communication is the first report of PKIs immunosuppressive action on the inductive steps of Ab-formation.

Lactic acid production in a cell retention continuous culture using lignocellulosic hydrolysate as a substrate.

The effect of lignocellulosic hydrolysate of crushed corn cobs on the kinetics of growth and lactic acid production of Lactobacillus casei and L. lactis in the cell retention continuous culture was studied. The continuous cultivations were carried out in a continuous flow stirred bioreactor combined in a recycle loop with an ultrafiltration module retaining all biomass and allowing the continuous removal of metabolites, including lactic acid, as a cell-free permeate. Based on computer-aided analysis of experimental data, a simple physiological model of lactic acid cultivation was developed. The parameters of the model were estimated by non-linear regression.

Asporogenic Bacillus megaterium mutant 27-36 degrades intrinsically short-lived proteins but fails to convert most of other proteins to a short-lived fraction.

Asporogenic mutant blocked in the 0-II sporulation stage degraded pulse-labelled proteins in the sporulation medium at the same rate as the parental strain for the first two hours. The degraded fraction was mostly composed of intrinsically short-lived proteins which were degraded even after enriching the medium with amino acids and growth resumption. Proteins accessible to degradation because of nutritional shift down formed a lesser proportion of this fraction. The acceleration of protein turnover in the parent strain during the irreversible sporulation phase was not developed in the mutant. A first order kinetic model of protein degradation was used for parameter estimation. Ca(2+)-dependent intracellular serine proteinase was synthesized in an inactive form, which was activated by increasing Ca2+ concentration to 30 mM.

An expert system applied to the physiological analysis of early stage of beer fermentation.

A fuzzy expert system was applied to the knowledge analysis of yeast physiology in the early stage of beer fermentation, when the wort was aerated. We used ergosterol and glycogen concentration in the wort as a suitable marker of physiological state of the cell population. The amount of both compounds influences the rate of fermentation, cell growth and the final taste of beer. The concentrations of ergosterol and glycogen including the number of cells can not be measured immediately during the relatively short aeration period, and incomplete experimental data are therefore found in laboratory logbooks. We therefore suggested that the fuzzy relation between the directly measurable dissolved oxygen concentration and the rate of ergosterol or glycogen formation should be identified and a fuzzy expert system should be used to analyze the behavior of the yeast.

External conditions influencing ethanol oxidation by resting cells of Candida utilis.

Effects of ethanol inhibition, initial pH and buffering capacity of media on the catabolic activity of nongrowing cells of Candida utilis were studied. Effects of external conditions on the kinetic of ethanol oxidation and cell respiration are described by mathematical models. The results revealed a significant influence of both the external pH and the buffering capacity of the medium on the kinetic parameters of catabolic activity. The inhibitory effect results in the bottleneck of one of the reaction of the citrate cycle, glyoxylate cycle or electron transfer in a respiratory chain although the total rate of ethanol dissimilation increases under these conditions.