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Öğe Analyses of Preoperative Presumptive Diagnosis in Lung and Mediastinal Lesions(Derman Medical Publ, 2010) Sahin, Ekber; Karadayi, Sule; Nadir, Aydin; Celik, Burcin; Sezer, Hafize; Kaptanoglu, MelihAim The aim of this study was to investigate the correlation of preoperative presumptive and final histological diagnosis in patients without previous histological evaluation. Matherial and Methods We enrolled sixty-five patients who were operated for lung and mediastinal lesions between December 2005 and December 2008. In all patients, three presumptive diagnosises were established and they were compared to final histological diagnosis. ROC curve was used for analysing data. Results Postoperative histological diagnosis were as follows: lung cancer 23.1 % (15/65), hydatid cyst 23.1% (15/65), sarcoidosis 13.8% (9/65), tuberculosis 9.2% (6/65) and other disease 30.8 % (20/65). Sensitivity of presumption in the diagnosis of lung cancer, hydatid cyst, tuberculosis and sarcoidosis were 80%, 93.3%, 50%, 66.7% respectively. Conclusion We think that the exploratory thoracotomy should be performed when the lung cancer and hydatid cyst are suspected for diagnosis. For accurate diagnosis of tuberculosis and sarcoidosis, more detailed and careful preoperative laboratory studies should be done.Öğe An analysis of 214 cases of rib fractures(HOSPITAL CLINICAS, UNIV SAO PAULO, 2011) Karadayi, Sule; Nadir, Aydin; Sahin, Ekber; Celik, Burcin; Arslan, Sulhattin; Kaptanoglu, MelihINTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) patients with an isolated rib fracture (RF1) (n = 50, 23.4%), 2) patients with two rib fractures (RF2) (n = 53, 24.8%), and 3) patients with more than two rib fractures (RF3) (n = 111, 51.9%). The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion), and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p < 0.05). Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p < 0.05). Two patients (4%) in group RF1, 2 patients (3.8%) in group RF2, and 5 patients (4.5%) in group RF3 (total n = 9; 4.2%) died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment.Öğe A case of non-Hodgkin's lymphoma presented with tension chylothorax(EKIN TIBBI YAYINCILIK LTD STI-EKIN MEDICAL PUBL, 2011) Sahin, Ekber; Celik, Burcin; Nadir, Aydin; Kaptanoglu, MelihWe present an unusual case of diffuse large B-cell lymphoma which initially presented as tension chylothorax. A 24-year-old man was admitted to our clinic with the complaints of dyspnea, fever, and sweating. Chest X-ray revealed a massive right pleural effusion. The patient was diagnosed with chylothorax and a right tube thoracostomy was performed. Thorax computed tomography revealed parenchymal infiltration in the right lower lobe, right hydropneumothorax, and multiple paratracheal lymphadenopathies. The general status of the patient was poor, and the submandibular lymph node was excised for pathological diagnosis. The general status of the patient gradually got worse and on the 13(th) day of the admission, intubation and mechanical ventilation were instituted. The pathological diagnosis of the lymph node was reported as diffuse large B-cell lymphoma, and the patient died only two days after the histopathological diagnosis. Chylothorax may arise as a complication of lymphoma. While, there are no reports on the frequency of this occurrence, it is associated with a high mortality rate when the patient presents with tension chylothorax.Öğe Diagnostic and therapeutic approaches in tracheobronchial rupture: analysis of 23 patients(EKIN TIBBI YAYINCILIK LTD STI-EKIN MEDICAL PUBL, 2010) Sahin, Ekber; Nadir, Aydin; Karadayi, Sule; Celik, Burcin; Manduz, Sinasi; Akkas, Yuecel; Kaptanoglu, MelihBackground: In this article we examined diagnostic and therapeutic results of tracheobronchial ruptures which we treated. Methods: In our study the records of 23 patients (19 mates, 4 females; mean age 21.0 +/- 15.8 years; range 1 to 64 years) who were admitted to and treated in our clinic between June 1992 and October 2008 due to tracheobronchial rupture caused by trauma or iatrogenic factors were examined retrospectively. Patients were evaluated in terms of injury type, localization of lesion. diagnostic and therapeutic methods. Results: A bronchus was ruptured in 17 patients (73.9%) and trachea was ruptured in six patients (26.1%). Bronchoscopy provided the diagnosis in 91%. Computed tomography was performed in four patients (17%). Eleven of the ruptures were in the right bronchial tree (47.8%), whereas six were in the left bronchial tree (26.1%) and six were in the trachea (26.1%). While surgical therapy was performed in 17 patients (73.9%), conservative therapy was administered in six (26.1%) patients. Morbidity occurred in two (8.7%) patients and one patient died (4.3%). Conclusion: Immediate or delayed surgical treatment can be successful in rupture or complete disruption of tracheobronchial ruptures. Multitrauma patients should be surgically treated as soon as cardiopulmonary status was stabilized. If there is a suspicion of tracheobronchial trauma. bronchoscopy should not be spared. If suspicion continues, repetitive bronchoscopy shouldn't be avoided.Öğe An experimental model to study pneumothorax in Rats(ACADEMIC JOURNALS, 2010) Akkas, M. D. Yucel; Sahin, Ekber; Celik, Burcin; Nadir, Aydin; Karadayi, Sule; Gumus, Cesur; Cinar, Ziynet; Kaptanoglu, MelihResearchers have used various techniques to form pneumothorax in animals, but to date, no standard method or rate of pneumothorax has been defined. We tried to develop a standard and a safe method of pneumothorax model in this study. 12 female Wistar Albino rats weighing 200-220 g were used. Two groups (6 rats in each) were formed. Open pneumothorax was formed by 0.5 cm incision through the right, 5(th) intercostal space. The first group was held in open pneumothorax position for 1 min and the second group, for 2 min and the incisions were sutured. After 48 h, computed tomography of the rats were obtained and the pneumothorax rates were measured. The mean pneumothorax value was greater in Group II (13.89%) than in Group I and it was statistically significant (p < 0.05). The above mentioned method produces low rates of pneumothorax (10 - 15%), without injuring lung tissue. It should be useful for researchers, who plan to study lung physiology with low rates of pneumotohorax.Öğe Is esophagoscopy necessary for corrosive ingestion in adults?(WILEY-BLACKWELL PUBLISHING, INC, 2009) Celik, Burcin; Nadir, Aydin; Sahin, Ekber; Kaptanoglu, MelihP>The aim of the study was to determine whether early esophagoscopy is really necessary for the patients who have ingested a corrosive agent. Patients who were followed up with the diagnosis of corrosive ingestion in our clinic between the years 1998 and 2008 were studied retrospectively. The data were collected through the medical records of the patients and from interviews with them. The analyzed parameters included age, gender, the nature and the amount of the ingested agent, whether the event was accidental or suicidal, diagnostic tools, treatment and the results of the treatment, and long-term follow up. Over a 10-year period, a total of 124 cases of corrosive ingestion cases were determined. Of these, 64 (51.6%) were male and 60 (48.4%) were female. The mean age was 38 +/- 17.5 years. The most commonly ingested corrosive agents were sodium hypochlorite in 50 (40.3%) patients and hydrochloric acid in 33 (26.6%) patients. The mean admission time for the emergency department after ingestion of the corrosive agent was 2.5 +/- 3.7 hours. Ingestion was accidental in 82% of the patients and as a result of a suicide attempt in 18%. The amount of ingested corrosive agent in the suicidal group (190 +/- 208.3 mL) was higher than that of accidental group (66 +/- 58.3 mL) (P = 0.012). Nine patients underwent esophagoscopy, six of which were performed in other clinical centers. Only three (2.4%) patients experienced esophageal stricture, which were treated with repeated dilatations. In the long-term follow up, we could get in touch with only 63 patients and none of them had complications due to corrosive ingestion. The follow-up period ranged from 1 to 120 months (median 45 +/- 29.2 months). Based on our study, early esophagoscopy appears to be unnecessary in adult patients who ingested the corrosive agent accidentally. A larger prospective study is needed to answer the question.Öğe The effects of chlorhexidine gluconate and silver nitrate on rabbit lung: an experimental study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2011) Sahin, Ekber; Elagoz, Sahande; Celik, Burcin; Nadir, Aydin; Karadayi, Sule; Akkas, Yucel; Kaptanoglu, MelihBackground: In this study, we investigated the effects of chlorhexidine gluconate and silver nitrate on the lungs and determine their utility in operations for pulmonary hydatid cysts. Methods: Thirty New Zealand Wistar albino rabbits weighing between 2750 and 3000 grams were used in the study and divided into three groups. In the first (control) group, normal saline (0.09% NaCl); in the second group, silver nitrate (0.5%); and in the third group, chlorhexidine gluconate (0.04%) was administered intrathraceally. Thirty days after the procedure, the tracheobronchial and parenchymal changes in the subjects were evaluated histopathologically. Tracheobronchial changes were evaluated with respect to tracheal pathology whereas peribronchial lymphocytic infiltration and parenchymal changes were evaluated with respect to interstitial lymphocytic infiltration, hemorrhage-edema, fibrosis and pneumonitis. Results: The rate of interstitial lymphocytic infiltration was higher in the chlorhexidine gluconate group than in the control group, and the rates of fibrosis and fibrin accumulation were higher in the silver nitrate group than in the control group. No statistically significant differences in other parameters were found between the groups. Conclusion: The results of the study indicate that chlorhexidine gluconate (0.04%) has minimal negative effects on the rabbit lung and tracheobronchial mucosa and is a more reliable agent than silver nitrate.Öğe Therapeutic approaches in tracheal stenosis: analysis of fifteen cases(EKIN TIBBI YAYINCILIK LTD STI-EKIN MEDICAL PUBL, 2010) Sahin, Ekber; Nadir, Aydin; Celik, Burcin; Karadayi, Sule; Manduz, Sinasi; Arslan, Sulhattin; Kaptanoglu, MelihBackground: In this study, results of treatment of patients who had tracheal stenosis were evaluated. Methods: The clinical records of 15 patients (6 males, 9 females; mean age 39+/-23.2 years; range 8 to 70 years) who were treated for tracheal stenosis between June 1992 and October 2008 were analyzed retrospectively. The diagnostic method, localization, therapeutic approach and results of tracheal stenosis were investigated. Results: Tracheal stenosis was due to tracheostomy in six, prolonged intubation in five and malignancy in four patients. Rigid bronchoscopy was the most frequent diagnostic tool. Eight patients were treated conservatively. Diathermic resection was the first treatment of choice in nine patients. Resection and end-to-end anastomosis was used in seven patients and tracheal stent was used in six patients. Stents of three patients were removed within 12 to 18 months. Median duration of hospitalization was 12 days. Morbidity was seen in four patients; mortality was seen in three patients. Conclusion: The success rate in tracheal stenosis treated by surgery is 71 to 97% and it is 65 to 70% by conservative methods. Surgical options should be considered first, but conservative methods should keep in mind.
