Intrapleural hyperthermic perfusion chemotherapy in subjects with metastatic pleural malignancies.

OBJECTIVES: Malignant pleural effusion (MPE) means poor prognosis in the majority of cases. Intrapleural Hyperthermic perfusion chemotherapy (HIPEC) looks promising approach for these patients. We aimed to investigate whether cytoreductive surgery followed by HIPEC provides any survival benefit in cases with metastatic MPEs. METHODS: Between January 2009 and December 2011, 19 patients with metastatic MPEs were treated with HIPEC following surgical interventions such as pleurectomy/decortication and/or lung resection (group 1). Comparison was done with historical control groups consisted of patients who received either talc pleurodesis or pleurectomy/decortication followed by systemic treatment for the management of metastatic MPEs between June 2007 and June 2008 (group 2 and 3). Statistical analyses including overall survival, disease free interval were done for the group comparisons. RESULTS: Median survival in group 1, 2 and 3 were 15.4, 6, 8 months, respectively. One year survival was 54.7% in group 1 where it was 0.6% and 0.8% in group 2 and 3, respectively. There was no operative mortality. Morbidity was occurred in 1 patient in group 1 (5.3%). CONCLUSIONS: HIPEC combined with cytoreductive surgery seems to be a promising treatment option for subjects with metastatic MPEs. Further studies are needed for the optimization of HIPEC method, drug of choice, and the best combination therapy for the multimodal treatment.

Antimicrobial and antioxidant activities of various extracts of Verbascum antiochium Boiss. (Scrophulariaceae).

Verbascum antiochium Boiss., a member of the Scrophulariaceae family, is endemic to Turkey. The extracts obtained from V. antiochium by increased polarity and direct methanol extraction were tested by the agar well diffusion method against various Gram-positive and Gram-negative bacteria and one fungus. The methanol/water extract exhibited a larger inhibition zone against both the Gram-negative and Gram-positive bacteria than the other extracts. Haemophilus influenzae was found to be the most sensitive bacterium among the bacteria tested. The antioxidant activities of the methanolic extract of V. antiochium were examined by two complementary test systems. The 50% inhibition activity of the methanolic extract of V. antiochium against the free radical 2,2-diphenyl-1-picrylhydrazyl was determined as 4.80 mg/mL. In the case of the linoleic acid system, oxidation of linoleic acid was inhibited by the methanolic extract of V. antiochium with 79.92% inhibition, which is close to the value of the synthetic antioxidant reagent, tert-butylated hydroxytoluene. The total phenolic components of V. antiochium were determined to be 92.71 mg of gallic acid equivalents/g. Iridoid glycosides, flavonoids, and saponins were detected as the major chemical constituents in the extract.