[Show abstract][Hide abstract] ABSTRACT: To evaluate the effects of oxidant/antioxidant mechanisms and levels of trace elements on trauma-stimulated moderate pulmonary contusions after vitamin E administration.
Sixty-three male Sprague Dawley rats were used. Animals were studied in 4 groups. Vitamin E (150 mg/kg) was injected intraperitoneally 30 min after trauma and on the first and second days. Blood samples were obtained for nitric oxide (NO) levels and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities. Zinc (Zn+2), copper (Cu+2), and iron (Fe+3) were measured in serum.
Lung contusion increased serum and tissue NO levels and SOD activities and decreased GSH-Px activities (P < 0.05). Vitamin E significantly (P < 0.05) decreased NO levels and SOD activities and increased GSH-Px. Serum Zn+2, Cu+2, and Fe+3 levels were statistically significantly influenced by the administration of vitamin E (P < 0.05). Group 4 had lower scores compared to Group 3 (P < 0.05) and no difference compared to Group 1 (P > 0.05).
These results suggest that treatment with vitamin E reduces lung oxidative stress and related mechanisms in isolated lung contusion as demonstrated by an experimental rat model.
No preview · Article · Jun 2015 · Turkish Journal of Medical Sciences
[Show abstract][Hide abstract] ABSTRACT: Introduction We investigated the prognostic effect of lymph nodes metastasis in aortopulmonary (AP) zone in resected non-small cell lung cancer of the left upper lobe (LUL). Methods Between 1998 and 2010, 181 patients with LUL carcinoma underwent complete resection and were retrospectively analyzed. The patients were divided into four groups according to N status: N0 (n = 68, 37.6%), N1 (n = 64, 35.3%), N2(5,6+) (only metastasized to stations 5 and/or 6, n = 36, 19.9%), and N2(7+) (only metastasized to stations 7, n = 13, 7.2%). N1 were divided according to single and multiple (N1(single) n = 49, N1(multiple) n = 15) or peripheral and hilar (N1(peripheral) n = 39, N1(hilar) n = 25). Results Overall 5-year survival rate was 55.1%. Five-year survivals were 76.1% for N0, 54.3% for N1, and 20.7% for N2. N1(peripheral) had a better survival than N1(hilar) (60.3 vs. 29.4%, p = 0.09). Five-year survival of N1(single) was 60.1%, whereas it was 36.6% for N1(multiple) (p = 0.02). Five-year survival rate was 24.6% for N2(5,6+). Skip metastasis for lymph nodes in AP zone (n = 13) was a factor of better prognosis as compared to nonskip metastasis (n = 23) (29.9 vs. 19.2%). There was no statistically significant difference between the N2(5,6+) and N1(hilar) (p = 0.772), although N1(peripheral) had a significantly better survival than N2(5,6+) (p = 0.02). AP zone metastases alone had a significantly worse survival than N1(single) (p = 0.008), whereas there was no statistically significant difference between the N1(multiple) and N2(5,6+) (p = 0.248). N2(7+) was not expected to survive 3 years after operation. They had a significantly worse prognosis than N2(5,6+) (p = 0.02). Conclusion LUL tumors with metastasis in the AP zone lymph nodes, especially skip metastasis, were associated with a more favorable prognosis than other mediastinal lymph nodes. However, the therapy of choice for lung cancer with N2(5,6+) has not been clarified yet.
Georg Thieme Verlag KG Stuttgart · New York.
No preview · Article · Apr 2015 · The Thoracic and Cardiovascular Surgeon
[Show abstract][Hide abstract] ABSTRACT: To analyze the protective activity of vitamin C on the lungs by assessing biochemical and histopathological analysi after performing an experimental isolated lung contusion model.
Fifty-four male Sprague-Dawley male rats were used. The rats were randomly separated into 4 groups Vitamin C (200 mg/kg) was injected intraperitoneally 30 min after trauma. Blood samples were obtained for myeloperoxidase (MPO) glutirthione peroxidase (GSH-Px), superoxide dismutase (SOD), and catalase (CAT) activities and malondialdehyde (MDA) levels Blood gas analysis and bronchoalveolar lavage was performed. The lung tissue was also extracted for histopathological examination.
The lung contusion enhanced MDA, SOD, CAT, and MPO and diminished GSH-Px. Vitamin C administration after th pulmonary contusion was found to diminish the level of MDA and the activities of SOD, CAT, and MPO and to enhance the level of GSH-Px (P < 0.05). Contusion-induced disrupted gas analysis and leukocyte infiltration were both resolved by the vitamin C.
The present results indicate that vitamin C administration attenuated the oxidative damage and morphological change induced by pulmonary contusion in an experimental rat study.
No preview · Article · Dec 2014 · Turkish Journal of Medical Sciences
[Show abstract][Hide abstract] ABSTRACT: Purpose:
Hydatid cyst (HC) disease is a zoonotic disease caused by the larvae of Echinococcus granulosus. We report our experience of treating HC manifesting aggressive characteristics.
Between January, 2010 and December, 2013, 40 patients underwent surgery for HC disease in our department. The subjects of this study were six patients whose disease followed an aggressive and invasive clinical course. The HC disease in these patients involved the vertebrae, chest wall, mediastinum, diaphragm, and lung, with destruction of the lung.
There were four men and two women, with a mean age of 47 years (range 12-81 years). Treatment consisted of cystectomy and additional procedures, such as corpectomy and resection of the chest wall, approaching the liver and spleen with phrenotomy and lobectomy. One patient suffered prolonged biliary drainage, and another had a bronchopleural fistula and atelectasis. One patient died of empyema 1 month postoperatively. The mean hospital stay was 9 days.
In some patients, HCs can act as an aggressive tumor, involving the surrounding tissues, organs, and even bony structures. Aggressive HCs may cause various sequelae and require extended surgical interventions in addition to cystectomy.
[Show abstract][Hide abstract] ABSTRACT: Objective
Some treatment modalities may cause losses in patients’ life comfort because of the treatment process. Our aim is to determine the effects of thoracic surgery operations on the patients’ quality of life.Materials and Methods
This is a multicenter and prospective study. A hundred patients, who had undergone posterolateral thoracotomy (PLT) and/or lateral thoracotomy (LT), were included in the study. Quality of life questionnaire (SF-36) was used to determine the changes in life comfort. SF-36 was performed before the operation, on the 1st month, 3rd month, 6th month and 12th month after the operation.Results72% (n=72) of the patients were male. PLT was performed to 66% (n=66) of the patients and LT was performed to 34% (n=34) of the patients. The types of resections in patients were pneumonectomy in 4 patients, lobectomy in 59 patients and wedge resection in 11 patients. No resection was performed in 26 patients.Thoracotomy caused deteriorations in physical-function (PF), physical role (RP), bodily pain (BP), health, vitality and social function scores. The deteriorations observed in the 3rd month improved in the 6th and 12th months. The PF, RP, BP and MH scores of the patients with lung resection were much more worsened compared to the patients who didn't undergo lung resection.Conclusion
Thoracic surgery operations caused substantial dissatisfaction in life comfort especially in the 3rd month postoperatively. The worsening in physical function, physical role, pain and mental health is much more in patients with resection compared to the patients who didn't undergo resection.
No preview · Article · Apr 2014 · The Clinical Respiratory Journal
[Show abstract][Hide abstract] ABSTRACT: Cervical necrotizing fasciitis (CNF) is a rare, rapidly advancing infection that involves the skin, the subcutaneous fibrofatty tissue, as well as the superficial and deep fascia and can cause life-threatening complications. The most frequent initiating factors in the head and neck region are a primary odontogenic infection, a peritonsillar infection, as well as posttraumatic or iatrogenic skin and mucosal injuries. Necrotizing fasciitis (NF) can expand within hours, and the reported mortality rate is up to 75% with delay interference. If the patients have any risk factors, poor prognosis can be seen. In this study, 1 patient with CNF with a history of peritonsillar infection and 2 patients with CNF who had a history of odontogenic infection with spreading to the temporal region and the mediastinum were described, with information of the literature and a clinical experience that was gained from 5 patients with NF who were seen at our clinic in the recent year, despite the fact that CNF was not seen up to last year. None of the patients had any risk factors. One of them had a worse clinical state with ascending infection to the temporal region, cranial nerve paralysis, and descending necrotizing mediastinitis, but he recovered from NF. After the oral intake began, dyspnea due to aspiration was seen and he died because of sepsis and multiorgan dysfunction. We aimed to attract attention to the importance of dental pathologies and increased mortality in a healthy patient.
No preview · Article · Nov 2013 · The Journal of craniofacial surgery
[Show abstract][Hide abstract] ABSTRACT: The aim of this study was to investigate the effects of caffeic acid phenethyl ester (CAPE) in the lungs by biochemical and histopathological analyses in an experimental isolated lung contusion model. Eighty-one male Sprague-Dawley rats were used. The animals were divided randomly into four groups: group 1 (n = 9) was defined as without contusion and without CAPE injection. Group 2 (n = 9) was defined as CAPE 10 μmol/kg injection without lung contusion. Group 3 (n = 36) was defined as contusion without CAPE-administrated group which consisted of four subgroups that were created according to analysis between days 0, 1, 2, and 3. Group 4 (n = 27) was defined as CAPE 10 μmol/kg administrated after contusion group divided into three subgroups according to analysis on days 1, 2, and 3. CAPE 10 μmol/kg was injected intraperitoneally 30 min after trauma and on days 1 and 2. Blood samples were obtained to measure catalase (CAT) and superoxide dismutase (SOD) activities and level of malondialdehyde (MDA) and for blood gas analysis. Trace elements such as zinc and copper were measured in serum. The lung tissue was also removed for histopathological examination. Isolated lung contusion increased serum and tissue SOD and CAT activities and MDA levels (p < 0.05). Both serum and tissue SOD, MDA, and CAT levels on day 3 were lower in group 4 compared to group 3 (p < 0.05). Further, the levels of SOD, MDA, and CAT in group 4 were similar compared to group 1 (p > 0.05). CAPE also had a significant beneficial effect on blood gases (p < 0.05). Both serum zinc and copper levels were (p < 0.05) influenced by the administration of CAPE. Histopathological examination revealed lower scores in group 4 compared to group 3 (p < 0.05) and no significant differences compared to group 1 (p > 0.05). CAPE appears to be effective in protecting against severe oxidative stress and tissue damage caused by pulmonary contusion in an experimental setting. Therefore, we conclude that administration of CAPE may be used for a variety of conditions associated with pulmonary contusion. Clinical use of CAPE may have the advantage of prevention of pulmonary contusion.
Full-text · Article · Sep 2012 · Biological trace element research
[Show abstract][Hide abstract] ABSTRACT: Objectives:
In our study, we aimed to investigate the anti-inflammatory mediator effects of budesonide (BS), an inhaled corticosteroid and interleukin-10 (IL-10) on a pulmonary contusion in an experimental rat model in which an isolated bilateral pulmonary contusion was created by blunt thoracic trauma.
Fifty-five male Sprague-Dawley rats were used in the study. Sham, control, BS and IL-10 groups were created. A pulmonary contusion was created by performing isolated blunt thoracic trauma in all groups except for the sham group. The trauma's severity was determined as 1.45 J. BS and IL-10 were administered orogastrically to the respective groups 30 min before trauma, and orogastrically and intraperitoneally, respectively, on the first and second days after the trauma. Only the blunt thoracic trauma was performed for the control group. SatO(2), PaO(2) and PaCO(2), blood glutathione, malondialdehyde (MDA) and tumour necrosis factor-α (TNFα) values were recorded on the zeroth, first, second and third days. The histopathological examination and the bronchoalveolar lavage cell count were performed on pulmonary tissues.
Blood gas analysis revealed that SatO(2) and PaO(2) values on the first and second days were significantly lower in the control, BS and IL-10 groups compared with the sham group (P < 0.05). The SatO(2) and PaO(2) values on the third day in the BS and IL-10 groups were higher than in the control group (P < 0.05). The mean MDA in the control group was higher than in the sham, BS and IL-10 groups (P < 0.05). The mean TNFα in the control group was higher than in the sham, BS and IL-10 groups (P < 0.05). Pulmonary pathology scoring in the control group was observed to be higher than in the sham, BS and IL-10 groups (P < 0.05).
In this rat experiment model in which an isolated pulmonary contusion was created by blunt trauma, BS and IL-10 were observed to reduce contusion severity in the lung and minimize the inflammatory reaction.
No preview · Article · Jun 2012 · European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery
[Show abstract][Hide abstract] ABSTRACT: Pleomorphic adenoma in the trachea is very rare. We report the case of a 46-year-old woman who had been treated for asthma for 12 months before the diagnosis of pleomorphic adenoma of the trachea was made. The tumour was defined by fiberoptic bronchoscopy in the mid 1/3 of the trachea obstructing nearly 90 % of the lumen. Through a collar incision and partial sternotomy, 3 cm segment of the trachea was resected and end-to-end anastomosis was performed.
Full-text · Article · Jun 2012 · General Thoracic and Cardiovascular Surgery
[Show abstract][Hide abstract] ABSTRACT: Tracheobronchial ruptures following blunt thoracic trauma are rare in children. To our knowledge, there is no reported case of tracheobronchial rupture due to compression under the barrel of a cannon. The involvement of both the trachea and right main bronchus is highly unusual. The case of a 16-year-old boy with both distal tracheal and right main bronchial ruptures following blunt chest trauma is herein reported, in which we emphasize the need for a prompt diagnosis and appropriate management.
[Show abstract][Hide abstract] ABSTRACT: Surgical processes that involve the carina pose a serious challenge to thoracic surgeons. Although techniques to allow resection and reconstruction have been developed, few institutions have accumulated sufficient experience to achieve meaningful results. There is still a debate about the indications and the morbidity and mortality rates for this type of surgery.
We have operated on six patients using a modified version of the tracheobronchial end-to-end and bronchial end-to-side anastomosis technique that was developed by Miyamoto and coworkers and reported in the English-language literature by Yamamoto and associates.
Five patients underwent tracheal sleeve right upper lobectomy, and one underwent carinal resection only with two main bronchi and the trachea. None of the patients we operated on had any postoperative complications.
We concluded that when used with adequate surgical performance this seldom-used technique can be applied safely and provide great benefits in particular cases.
Full-text · Article · Feb 2012 · General Thoracic and Cardiovascular Surgery
[Show abstract][Hide abstract] ABSTRACT: The purpose of this retrospective study was to analyze our experience with mediastinal cysts, emphasizing the clinical presentations and results of surgery.Thirty-two patients with mediastinal cysts underwent surgery from January 2000 through June 2005. The records of these patients were reviewed for age at presentation, sex, signs and symptoms at presentation, results of the imaging techniques, types of mediastinal cysts, location and size of cysts, types of surgical procedure, length of hospital stay, early postoperative complications, death, and other follow-up information.The 32 mediastinal cysts comprised 12 bronchogenic, 9 pericardial, 7 thymic, and 2 enteric cysts, together with 2 cystic teratomas. Overall, 14 of the 32 patients with mediastinal cysts were asymptomatic. The surgical approach was thoracotomy in 30 patients and median sternotomy in 2 patients. The mean length of hospital stay was 7.7 ± 2.6 days. All patients were free from recurrence during the mean follow-up period of 4.4 ± 3.3 years.Surgery for mediastinal cysts is associated with low morbidity and mortality rates and a very low recurrence rate. It offers a definitive diagnosis and cure, avoiding the higher morbidity and mortality risks associated with conservative observation.
Preview · Article · Aug 2011 · Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital
[Show abstract][Hide abstract] ABSTRACT: In the 1997 revision of the TNM staging system for lung cancer, patients with T3N0M0 disease were moved from stage IIIA to stage IIB since these patients have a better prognosis. Despite this modification, the local lymph node metastasis remained the most important prognostic factor in patients with lung cancer. The present study aimed to evaluate the prognosis of patients with T3N1 disease as compared with that of patients with stages IIIA and IIB disease. During 7-year period, 313 patients with non-small cell lung cancer (297 men, 16 women) who had resection were enrolled. The patients were staged according the 2007 revision of Lung Cancer Staging by American Joint Committee on Cancer. The Kaplan-Meier statistics was used for survival analysis, and comparisons were made using Cox proportional hazard method. The 5-year survival of patients with stage IIIA disease excluding T3N1 patients was 40%, whereas the survival of the patients with stage IIB disease was 66% at 5 years. The 5-year survival rates of stage III T3N1 patients (single-station N1) was found to be higher than those of patients with stage IIIA disease (excluding pT3N1 patients, P = 0.04), while those were found to be similar with those of patients with stage IIB disease (P = 0.4). Survival of the present cohort of patients with T3N1M0 disease represented the survival of IIB disease rather than IIIA non-small cell lung cancer. Further studies are needed to suggest further revisions in the recent staging system regarding T3N1MO disease.
[Show abstract][Hide abstract] ABSTRACT: Bronchoesophageal fistulas associated with traction diverticula are exceptional. We presented a case of traction diverticulum
that fistulized to the bronchial tree and resulted in segmentary bronchiectasis. We encountered a successful repair of esophagobronchial
fistula communicated to esophageal diverticulum. To our knowledge, there is no reported case of traction diverticulosis causing
esophagobronchial fistula and bronchiectasis in a similar fashion.
Preview · Article · Dec 2010 · Indian Journal of Thoracic and Cardiovascular Surgery
[Show abstract][Hide abstract] ABSTRACT: J Surg Arts, 2009;2(1):30-33. ABSTRACT Hernia of Morgagni, rarely seen in adults, is a congenital herniation of the abdominal content into the thoracic cavity through a retrosternal diaphragmatic defect. We present a case of an incarcerated hernia of Morgagni in a 72-year-old woman admitted to our clinic with breathlessness and symptoms of intestinal obstruction. The diagnosis was made preoperatively by chest radiography, barium enema, and computed tomography. The herniated colon and omentum were reducted into the abdomen. The diaphragmatic defect was repaired with a mesh, following resection of the strangulated omentum. As hernia of Morgagni always has a risk of causing severe complications, such as intestinal obstruction, it should be operated even if it is asymptomatic. ÖZET Erişkinlerde nadiren görülen Morgagni hernisi, abdominal organların retrosternal diyafragmatik defekten göğüs boşluğuna konjenital herniasyonudur. Burada barsak obstruksiyonu semptomları ve nefes darlığı ile kliniğimize kabul edilen inkarsere Morgagni hernili 72 yaşında kadın hasta sunuldu. Tanı preoperatif direk radyografi, baryumlu grafi ve bilgisayarlı tomografi ile konuldu. Strangule omentumun rezeksiyonundan sonra diyafragmatik defekt prolen mesh ile kapatıldı. Morgagni hernisi barsak obstrüksiyonu gibi ciddi komplikasyonlara sebep olma riski taşıdığından, asemptomatik olsa dahi cerrahi olarak onarılmalıdır. Anahtar Kelimeler: Morgagni hernisi, barsak obstrüksiyonu, operasyon.
[Show abstract][Hide abstract] ABSTRACT: Traumas are among important causes of morbidity and mortality in the pediatric group. Our aim was to evaluate the predicting effects of general trauma scores on mortality and morbidity rates.
The files of 74 patients, who were admitted to our hospital with trauma between the years 2006 and 2008, were retrospectively investigated. Patients' ages, sex, types of trauma, the time between the trauma and entrance to the hospital, vital and laboratory findings, length of hospital stay, length of intensive care unit (ICU) stay, surgical interventions, the organs affected by the trauma, morbidity, and mortality rates were recorded., glasgow coma scale (GCS), abbreviated injury scale (AIS), trauma score-injury severity score (TRISS), revised trauma score (RTS), injury severity score (ISS), pediatric trauma score (PTS), specific trauma scores for lung, liver, and spleen were calculated using the data in the files.
The mean age of patients was 7.0+/-4.34 (1-16) years and 50% of them were men. The types of the trauma were blunt in 66 (89.2%) patients, penetrating in 5 (6.8%) patients and injury due to gun shot in 3 (4.1%) patients. The mean time between the trauma and entrance to the emergency service was 80.40+/-36.67 (10-120) min. Emergency operation and elective surgery was performed in 13 (17%) and 20 (27%) patients, respectively. The mean length of hospitalization was 4.50+/-7.93 (1-35) days.Seven (9.5%) patients needed ICU. The morbidity and mortality rates were 60.8% (n=45) and 2.7% (n=2), respectively. AIS, ISS, TRISS and PTS were independent predictors of morbidity (p<0.05). AIS and ISS were independent predictors of the length of hospital stay (p<0.05). RTS, TRISS, ISS and PTS were independent predictors of the need for ICU (p<0.05). Among laboratory findings, blood glucose, AST and ALT were found to be independent predictors of liver trauma.
ISS was found to be more valuable than other trauma scoring systems for prognostic evaluation of pediatric trauma patients. On the other hand, blood glucose, AST, and ALT are easily available, cheap, and valuable alternative laboratory findings in prognostic evaluation.
No preview · Article · Dec 2008 · Pediatric Surgery International