Effects of Streptokinase and Deoxyribonuclease on Viscosity of Human Surgical and Empyema Pus

Simpson, Graham; Roomes, David; Heron, M.L.

doi:10.1378/chest.117.6.1728

Cited by 112 publications

(82 citation statements)

References 17 publications

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“…In addition, we did not observe any significant correlation between the viscosity and viable cell density of the pus. The DNA content of purulent material is known to influence its viscosity (19). It is likely that the increased necrotic fraction on aspiration of the pus (due to breakdown of the viable cells) may result in the release of the nuclear DNA that enhances the viscosity of the pus.…”

Section: Discussionmentioning

confidence: 99%

Biological correlates of diffusivity in brain abscess

Mishra

Gupta

Saksena

et al. 2005

Magnetic Resonance in Med

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Restricted diffusion in brain abscess is assumed to be due to a combination of inflammatory cells, necrotic debris, viscosity, and macromolecules present in the pus. We performed diffusion-weighted imaging (DWI) on 41 patients with proven brain abscesses (36 pyogenic and five tuberculous), and correlated the apparent diffusion coefficient (ADC) from the abscess cavity with viable cell density, viscosity, and extracellular-protein content quantified from the pus. On the basis of the correlation between cell density and ADC in animal tumor models and human tumors in the literature, we assumed that the restricted ADC represents the cellular portion in the abscess cavity. We calculated restricted and unrestricted lesion volumes, and modeled cell density over the restricted area with viable cell density per mm 3 obtained from the pus. The mean restricted ADC in the cavity (0.65 ؎ 0.01 ؋ 10 -3 mm 2 /s) correlated inversely with restricted cell density in both the pyogenic (r ‫؍‬ -0.90, P ‫؍‬ <0.05) and tuberculous (0.60 ؎ 0.04 ؋ 10 -3 mm 2 /s, r ‫؍‬ -0.94, P ‫؍‬ <0.05) abscesses. We conclude that viable cell density is the main biological parameter responsible for restricted diffusion in brain abscess, and it is not influenced by the etiological agents responsible for its causation. Magn Reson Med 54:878 -885, 2005.

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Section: Discussionmentioning

confidence: 99%

Biological correlates of diffusivity in brain abscess

Mishra

Gupta

Saksena

et al. 2005

Magnetic Resonance in Med

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“…This reduces operative risk (56) and hospital stay (4), and improves prognosis (57). Deoxyribonuclease (Dnase) can reduce purulent chest fluid viscosity (58). In the study on the combination of tPA + Dnase in the pleural cavity, pleural effusion drainage volume, operative referral rate, hospital stay and death rate in the treatment group significantly improved, compared to those in the control group (4,59); in a safe and effective manner (60).…”

Section: Intrapleural Cavity Injectionmentioning

confidence: 99%

Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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Pleural cavity infection continuously seriously threatens human health with continuous medical progress. From the perspective of pathophysiology, it can be divided into three stages: exudative stage, fibrin exudation and pus formation stage, and organization stage. Due to the pathogenic bacteria difference of pleural cavity infection and pulmonary infection, it is very important for disease treatment to analyze the bacteria and biochemical characteristics of the infectious pleural effusion. Most prognoses of patients have been relatively good, while for some patients, the complicated parapneumonic effusion or empyema could be evolved. Antibiotic treatment and sufficient drainage are the foundation for this treatment. No evidence can support the routine use of a fibrin agent. However, it has been reported that the plasminogen activator and deoxyribonuclease can be recommended to be applied in the pleural cavity. In case of failure on conservative medical treatment, operative treatment can be applied such as thoracoscopy and pleural decortication.According to the clinical characteristics of these patients, it is a key to research prognosis, as well as early evaluation and stratification, in the future.

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“…The answer is probably that streptokinase alone did not produce sufficient clearance of pleural fluid -possibly because infected pleural fluid is viscous, lumpy, and resistant to tube drainage. 19,20 Streptokinase does not improve these characteristics 19,20 ; it simply breaches the barriers between pockets of pus. Therefore, despite the partial unification of the pleural collection, the fluid may still fail to drain adequately, because it cannot pass down the chest tube.…”

Section: Subgroup Analysesmentioning

confidence: 99%

“…If this is true, then reducing the viscosity of pus may improve outcomes in pleural infection; DNase is a candidate for this role, since it reduces viscosity by fragmenting the free uncoiled DNA found in pus. 19,20 This is the rationale for its use in airway clearance in cystic fibrosis. In pleural infection, data from both in vitro studies 19,20 and case reports on clinical use 22 suggest that DNase may also be helpful in draining empyema.…”

Section: Subgroup Analysesmentioning

confidence: 99%

See 1 more Smart Citation

U.K. Controlled Trial of Intrapleural Streptokinase for Pleural Infection

2005

N Engl J Med

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Effects of Streptokinase and Deoxyribonuclease on Viscosity of Human Surgical and Empyema Pus

Cited by 112 publications

References 17 publications

Biological correlates of diffusivity in brain abscess

Biological correlates of diffusivity in brain abscess

Infectious pleural effusion status and treatment progress

U.K. Controlled Trial of Intrapleural Streptokinase for Pleural Infection

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