Effects of platelet-rich plasma on cartilage regeneration after costal cartilage resection: a stereological and histopathological study.

BACKGROUND: In cases of congenital chest wall deformities, it is important to maintain the flexibility of the chest wall after rib cartilage resection. In this study, we aimed to determine the regeneration capability of cartilage and the effects of platelet-rich plasma (PRP) on the regeneration process. METHODS: A total of 16 four-week-old New Zealand rabbits were used in this study. In the 4th-5th right costal cartilages, the perichondrial sheaths were dissected and costal cartilages were excised. Then, the perichondrial sheaths were closed with absorbable material in the sham group (n = 8), and this was done after replacing PRP in the PRP group (n = 8). The left costal cartilages of the animals were used as controls. The volumes of the costal cartilages and their perichondrial sheaths were estimated using Cavalieri's principle. In addition, the mean numerical densities of the chondroblasts and chondrocytes per square millimetre were estimated using unbiased counting frames. RESULTS: In the PRP and sham groups, the volumes of the cartilages and perichondrial sheaths were higher than those of the control group (p < 0.05). The numerical densities of the chondroblasts and chondrocytes increased more in the PRP group than in the sham group (p < 0.05). CONCLUSIONS: Applying PRP after resection may provide better healing and faster regeneration of cartilage.

The effect of minimally invasive surgical repair on the lung volumes of patients with pectus excavatum.

OBJECTIVES: To assess the increase in lung volume after Nuss surgery in patients with pectus excavatum (PE) by using stereological methods and to evaluate the correlation between the lung volume and spirometry findings. METHODS: Twenty patients, treated for PE between 2008 and 2010, were evaluated prospectively. They underwent preoperative chest radiography, computed thorax tomography (CTT), and spirometry. Thereafter, the Haller index was calculated for each patient. In the third postoperative month, CTT and spirometry were repeated.Lung volumes and volume fractions were evaluated using CTT images, applying the Cavalieri principle for stereological methods. Then the correlation between the pre- and postoperative values of the lung volumes with spirometry findings was determined. RESULTS: Volumes of the right and left lungs were calculated stereologically, using CTT images. Postoperative volume increase of ∼417.6 ± 747.6 mL was detected. The maximum volume increase was observed in the left lung. In the postoperative period, the total volume increase and the volume increase detected in the left lung were found to be statistically significant (p < 0.05).The preoperative correlation coefficients (r) for forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow 25 to 75% were 0.67, 0.68, and 0.61, respectively; the postoperative r figures were 0.43, 0.42, and 0.35, respectively. Although there was a strong correlation between the preoperative lung volume and spirometry findings (p < 0.05), no correlation was observed between the postoperative lung volume and spirometry findings (p > 0.05). CONCLUSIONS: Postoperative pulmonary volume increase occurs in patients with PE after Nuss surgery. However, postoperative spirometry findings may not reflect morphological improvement because pain restricts thoracic movements. Therefore, in patients with PE, quantitative evaluation of the results of surgical repair is possible using the CTT images through a combination of stereological methods.

Postoperative lung volume change depending on the resected lobe.

OBJECTIVES: The aim of this study was to evaluate the lung volume changes depending on the resected lobes. The changes were quantitatively evaluated using stereological methods on computed tomography images and by pulmonary function tests (PFTs). METHODS: The study subjects included 30 patients who underwent lung resection. Of these, 26 patients underwent lung resection due to non-small cell lung cancer and 4 patients for benign reasons. Patients were classified into the following six groups according to the resected lobes and lungs: right lower lobectomy, right upper lobectomy, left lower lobectomy, left upper lobectomy, right pneumonectomy, and left pneumonectomy cases. All patients were evaluated with the PFT and computed thorax tomography (CTT), preoperatively and in the postoperative 3rd month. Volume changes due to resection were estimated on CTT scans using the Cavalieri principle of the stereological methods, and their relationships to the PFTs were evaluated. RESULTS: Stereologically estimated data showed that the volume loss was 19.01% in upper lobectomy and 5.57% in lower lobectomy (p < 0.05). The highest volumetric increase of the contralateral lung and minor volume loss of the ipsilateral lung was observed in lower lobectomy. After right lower lobectomy, the highest postoperative volume increase was observed at the contralateral lung and the least volume loss in the remaining ipsilateral lung. In PFT, forced vital capacity (FVC) decreased to 3.07% after lower lobectomy whereas it decreased to 11.94% after upper lobectomy. FVC revealed that no significant change occurred after right lower lobectomy (p < 0.05). CONCLUSIONS: Although the parenchyma resected in lower lobectomy is larger, the postoperative total lung volume reduction is less than that of upper lobectomy. After lower lobectomy, postoperative compensation is achieved specifically by the expansion of contralateral lung, together with the remaining ipsilateral lung.

Endobronchial lipoma: a rare cause of bronchial occlusion.

Benign neoplasms of the endobronchial tree are uncommon, and among them lipomas are the most uncommon. Endobronchial lipoma is histologically benign in character but may cause bronchial obstruction. We describe a 47-year-old woman with an endobronchial lipoma arising from the right main bronchus which was treated as asthma for 4 years.