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Through examination of the pharmacologic characteristics of two novel agents, we titrated an optimized combination of bromelain and <jats:italic>N<\/jats:italic>\u2010acetyl cysteine (NAC) that demonstrates <jats:italic>in vitro<\/jats:italic> and <jats:italic>in vivo<\/jats:italic> efficacy in the dissolution of mucinous ascites from PMP. In the <jats:italic>in vitro<\/jats:italic> experiments, 1 g of mucin was incubated in varying concentrations of bromelain (0\u2013400 \u00b5g\/ml) and NAC (0\u20135%) individually followed by a combination before arriving at a therapeutic combination dose of 300 \u00b5g\/ml bromelain\u2009+\u20094% NAC. This established an effective dose of bromelain 300 \u00b5g\/ml\u2009+\u20094% NAC at pH 7.0, when tested in a rat model implanted with 3 g of mucin intraperitoneally (IP). IP administration of the drug in a rat model of PMP was shown to result in mucin disintegration within 72 hr with no toxicity observed.<\/jats:p>","DOI":"10.1002\/ijc.28380","type":"journal-article","created":{"date-parts":[[2013,7,11]],"date-time":"2013-07-11T05:04:52Z","timestamp":1373519092000},"page":"478-486","source":"Crossref","is-referenced-by-count":43,"title":["A formulation for <i>in situ<\/i> lysis of mucin secreted in pseudomyxoma peritonei"],"prefix":"10.1002","volume":"134","author":[{"given":"Krishna","family":"Pillai","sequence":"first","affiliation":[{"name":"UNSW Department of Surgery St George Clinical School Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javed","family":"Akhter","sequence":"additional","affiliation":[{"name":"UNSW Department of Surgery St George Clinical School Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terence C.","family":"Chua","sequence":"additional","affiliation":[{"name":"UNSW Department of Surgery St George Clinical School Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Morris","sequence":"additional","affiliation":[{"name":"UNSW Department of Surgery St George Clinical School Kogarah NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,8,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000152015.76731.1f"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/ejso.2000.1038"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-007-9691-2"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v2.i1.44"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10434-999-0727-7"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.7166"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-003-4084-9"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-011-1303-8"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1042\/bj2740679"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1042\/bj2610637"},{"key":"e_1_2_5_12_1","first-page":"859","article-title":"Mucolytics, expectorants, and mucokinetic medications","volume":"52","author":"Rubin BK","year":"2007","journal-title":"Respir Care"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043900"},{"key":"e_1_2_5_14_1","first-page":"205","article-title":"Future therapeutic treatment of COPD: struggle between oxidants and cytokines","volume":"2","author":"Boer WI","year":"2007","journal-title":"Int J Chron Obstruct Pulmon Dis"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S3735"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1021\/jf60176a003"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00540-008-0612-8"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197511)36:5<1834::AID-CNCR2820360539>3.0.CO;2-6"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90327-3"},{"key":"e_1_2_5_20_1","first-page":"103","article-title":"Mucinous cystadenocarcinoma of the appendix with pseudomyxoma peritonei presenting as total uterine prolapse. 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