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    Comparison of side effects of oxytetracycline and talc pleurodesis: an experimental study
    (Bmc, 2010) Gözübüyük, Alper; Özpolat, Berkant; Çiçek, Ali Fuat; Çaylak, Hasan; Yücel, Orhan; Kavaklı, Kuthan; Genç, Onur
    Background: Chemical pleurodesis is widely recommended in the treatment of refractory pleural effusion or pulmonary air leak of different etiologies. Although several agents have been used, many questions have remained unanswered about their toxicity. Talc is the most commonly used agent for the treatment, with rare, serious complications reported. Oxytetracycline pleurodesis in clinical practice has been described in a few studies, but literature reveals no experimental studies using this agent. We performed a prospective, randomized, observer-blinded, controlled study to evaluate the changes in lung histology and systemic response to pleurodesis with oxytetracycline and talc in acute and subacute phases in a rat model. Methods: Forty-two male albino Wistar rats were divided into three groups and 3 subgroups with 7 animals in each. Group 1 was given oxytetracycline, 35 mg/kg; Group 2 was given talc slurry, 60 mg/kg in 0.5 mL saline solution, and Group 3 was given only 0.5 mL saline intrapleurally. In subgroups "a" the nimls were sacrificed at the postoperative 72(nd) hour and, in subgroups "b", on the postoperative day 7. The surfaces were graded by microscopic examination. Results: Oxytetracycline produced alveolar collapse, hemorrhage, edema, inflammation at the postoperative 72(nd) hour and hemorrhage on the postoperative day 7, while talc produced significant edema, inflammation, proliferation, fibrosis at the postoperative 72(nd) hour and hemorrhage, edema, inflammation, proliferation, and fibrosis on the postoperative day 7 (p < 0,0042). Talc produced significant edema compared to oxytetracycline on the postoperative day 7. On contralateral side, oxytetracycline and talc produced significant hemorrhage on the postoperative day 7 (p < 0.0042). Conclusions: Both agents were shown to produce pulmonary lesions. In acute phase, the pulmonary side effects of oxytetracycline were more pronounced, whereas the side effects of talc were prolonged to subacute phase. We propose that the occasional side effects in humans may be related to these changes as were observed in our rat model, and like talc, oxytetracycline must be used cautiously in patients with limited respiratory function.
  • Küçük Resim
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    Meteorological Conditions Related to the Onset of Spontaneous Pneumothorax
    (Tohoku Univ Medical Press, 2009) Özpolat, Berkant; Gözübüyük, Alper; Koçer, Bülent; Yazkan, Rasih; Dural, Koray; Genç, Onur
    Spontaneous pneumothorax is defined as the rupture of bleb or emphysematous bullae that develop just beneath the pulmonary pleura. Weather changes may influence the incidence of spontaneous pneumothorax. The aim of this study was to examine the influence of rainfall, temperature and atmospheric pressure changes on the onset of spontaneous pneumothorax. The study involved 669 spontaneous pneumothorax admissions to three reference hospitals in Ankara, Turkey between 1996 and 2006 (612 males and 57 females with the mean age of 34.0 +/- 15.5 years). The meteorological data were obtained from Turkish State Meteorological Services for temperature, atmospheric pressure, and rainfall. The correlation between these values and spontaneous pneumothorax clusters, which was defined as the admission of at least two patients with pneumothorax within three days of each other, was evaluated. Among 669 episodes of spontaneous pneumothorax, 472 (70.5%) occurred in 188 clusters. When compared to days without spontaneous pneumothorax, the amount of average rainfall on the day of admission with spontaneous pneumothorax, one day before and two days before the admission was significantly high. Similarly, the atmospheric pressure on one day and two days before the admission of spontaneous pneumothorax patients was significantly low. In addition, maximum temperature level was significantly lower on admission day of spontaneous pneumothorax patients compared to those on the days without spontaneous pneumothorax. This largest series of the literature shows that spontaneous pneumothorax occurs in clusters and suggests that rainfall, temperature and falls in atmospheric pressure might play a role in the pathophysiology of spontaneous pneumothorax.