[Show abstract][Hide abstract] ABSTRACT: Dasatinib is a tyrosine kinase inhibitor which is used for the treatment of patients with chronic myeloid leukemia (CML) resistant or intolerant to imatinib. Dasatinib can cause fluid retention in some patients, leading to peripheral edema and pleural effusion. Recognition of these symptoms as a potential complication of dasatinib will help prevent unnecessary investigations and facilitate adequate management. We report a patient with blastic phase CML. In patients with advanced phase CML an initial dose of dasatinib is recommended as 70 mg twice daily. We observed that 100 mg once daily dose of dasatinib could control the blastic phase of CML with less toxicity.
Full-text · Article · Mar 2013 · Erciyes Tip Dergisi
[Show abstract][Hide abstract] ABSTRACT: Objective: Sternal fracture (SF) occurs as a result of trauma or a pathological process. In this study, patients with SF were evaluated in terms of traumatic and atraumatic etiology, diagnosis and treatment. Material and Methods: Between 2006-2010; fracture etiology, location, shape, associated pathology, treatment modalities, complications and length of hospital stay were reviewed retrospectively in 13 patients with SF. In all cases, the lateral chest X-ray and electrocardiogram (ECG) had been performed. Cardiac enzymes had been measured in patients with traumatic etiology. Results: Of SF subjects, 11 had a traumatic etiology and 2 had an atraumatic etiology (osteoporosis). Sternal fracture was located in the corpus of the sternum in 9 patients, and in the manubrium in 4 cases, while it was displaced in 5 patients, and non-displaced in 8 cases. The ECG changes in five patients, elevated cardiac enzymes in 7 patients and pathology in echocardiography in 3 cases were detected. The most common injuries were associated with rib fractures (54.5%) and extremity fractures (27.3%), respectively. There was a vertebral osteoporotic fracture in two patients with atraumatic SF. One case underwent surgical fixation, while three patients underwent tube thoracostomy. Conclusion: Whether or not accompanying trauma, SF should be considered and sternum X-ray should be requested in patients presenting with chest pain, and especially when an atraumatic fracture is detected, osteoporosis should be kept in mind among the etiological causes. ECG monitoring of patients for cardiac injury, cardiac enzyme monitoring and echocardiography should be done if necessary.
[Show abstract][Hide abstract] ABSTRACT: Hydatid cyst disease, endemic in Eastern region of Turkey, is a significant parasitic public health problem. In this study, pleural complications of hydatid cysts were presented in 76 cases.
In our study, of the 412 pulmonary hydatid cyst cases operated on between 2003 and 2011, 76 cases had ruptured into the pleura for various reasons, and the different clinicoradiological presentations were evaluated retrospectively. The age distribution of the cases was between 7 and 56 years, and the mean age was 26.20±13.04.
The most frequent symptom due to pleural rupture in patients was dyspnea (44 cases, 57.8%). Etiologically, iatrogenic perforation was detected in four cases and thoracic trauma in nine cases (six car accidents and three falls from a height). An anthelmintic drug use history was found in three cases of ruptured pleura. Spontaneous perforation was detected in the other 60 (78.9%) cases. Two cases that were admitted to the emergency unit and were immediately administered a tube thoracostomy developed tension pneumothorax. In addition, 21 cases had hydropneumothorax, 17 had pneumothorax, and 36 had pleurisy. Morbidity was observed in 30 cases (39.4%). Atelectasis was the most frequent cause of morbidity in these patients (10 cases). The mean duration of hospitalization was determined to be 12.26±2.90 days.
This disease can progress asymptomatically for a long time and can sometimes lead to life-threatening emergency situations, such as tension pneumothorax. The delayed admission of a patient to a physician causes the disease to become more complicated and to increase the morbidity and mortality rates. Treatment of the disease is in the form of surgery. Possible parenchymal protection should be applied in surgical treatment, and anatomic resection should not be performed unless necessary.
No preview · Article · Aug 2012 · Eurasian Journal of Medicine
[Show abstract][Hide abstract] ABSTRACT: Right middle lobe syndrome is a rare entity in children, causing high morbidity. Our experience of these patients including their clinical and laboratory characteristics, indications forsurgical management, postoperative courses, and follow-up results was evaluated.
A retrospective analysis was performed involving 20 children with right middle lobe syndrome who were hospitalized and treated with surgical resection of the right middle lobe in Van Training and Research Hospital and Yüzüncüyil university hospital, Turkey, between January 2002 and January 2011.
The mean age of the patients was 10.5 years (range, 5 to 15 years). Twelve patients were boys and eight were girls. The most frequent symptom was chronic cough (75%). Hemoptysis was present in two (10%) patients. One patient was being treated for asthma. 25% positive cultures were identified among the patients. Streptococcus pneumoniae was the most frequently identified agent in sputum. All patients underwent chest computed tomography. There were bronchiectasis in 11 (55%) patients, atelectasis and bronchiectasis in five (25%) patients, and destroyed lung in four (20%) patients. A narrowed middle lobe bronchus was shown in 15 (75%) patients. Bronchoscopy was performed in 18 (90%) patients. Stenosis due to external compression was seen in 12 (60%) patients, hyperemia and bronchitis in two (10%) patients, granulation tissue in two (10%) patients, and dense secretions in two (10%) patients. A history of doctor-diagnosed tuberculosis was present in two (10%) patients. These patients had completed antituberculous treatment. The patients had been symptomatic for the last 1 to 10 years (mean, 4 years) and had received several medical treatments. All patients (totally 20 patients) underwent right middle lobe resection. In one patient, a bronchial abnormality was found intraoperatively. One patient died on postoperative day 10 due to a brain abscess. Three other patients had postoperative complications (15%). Mean duration of follow-up of the patients was 4.5 years (range, 2 months to 12 years). Seventeen patients were asymptomatic, and two patients had improved.
Children with right middle lobe syndrome unresponsive to medical treatment should undergo early lobe resection to avoid serious complications and the progression of the disease to other segments or lobes.
[Show abstract][Hide abstract] ABSTRACT: Although the prevalence of bronchiectasis decreased significantly in developed countries, in less developed and in developing countries, it still represents a significant cause of morbidity and mortality. The aim of this retrospective study is to present our surgical experiences, the morbidity and mortality rates and outcome of surgical treatment for bronchiectasis.
We reviewed the medical records of 129 patients who underwent surgical resection for bronchiectasis between April 2002 and April 2010, at Van Training and Research Hospital, Thoracic Surgery Department. Variables of age, sex, symptoms, etiology, and surgical procedures, mortality, morbidity and the result of surgical therapy were analyzed retrospectively.
Mean age was 21.8 year (the eldest was 67 year, the youngest was 4 years-old). Male/female ratio was 1.86 and 75% of all patients were young population under the age of 40. Bilateral involvement was 14.7%, left/right side ratio according to localization was 2.1/1. The most common reason for bronchiectasis was recurrent infection. Surgical indications were as follows: recurrent infection (54%), hemoptysis (35%), empyema (6%), and lung abscess (5%). There was no operative mortality. Complications occurred in 29 patients and the morbidity rate was 22.4%. Complete resection was achieved in 110 (85.2%) patients. Follow-up data were obtained for 123 (95%) of the patients. One patient died during follow-up. The mean follow-up of this patient was 9 months. Mean postoperative hospitalization time was 9.15 ± 6.25 days. Significantly better results were obtained in patients who had undergone a complete resection.
Surgical treatment of bronchiectasis can be performed with acceptable morbidity and mortality at any age. The involved bronchiectatic sites should be resected completely for the optimum control of symptoms.
Full-text · Article · Dec 2011 · Journal of Cardiothoracic Surgery
[Show abstract][Hide abstract] ABSTRACT: Co-existence of chylothorax and chyloabdomen is a rare clinical entity. Apart from surgery and extra-surgical trauma, malignancies, liver cirrhosis, nephrotic syndrome, thrombosis in the superior vena cava and acute pancreatitis play roles in the etiology. The case presented in this article was a 35-year-old woman, and the chronic infectious pathology in the cytology, plus the other supportive nonspecific infection parameters prompted us in establishing this diagnosis. Obstruction in the abdominal lymphatics leads to chylous ascites and chylothorax develops in due course. Similar to our case, the clinical entities of chylothorax and chyloabdomen of nonspecific infectious origin may co-exist in the same patient.
Preview · Article · Dec 2011 · Eurasian Journal of Medicine
[Show abstract][Hide abstract] ABSTRACT: The purpose of the study was to compare serum concentrations of some elements [zinc (Zn), copper (Cu), manganese (Mn), magnesium (Mg), lead (Pb), iron (Fe), cadmium (Cd) and cobalt (Co)] in acute leukemia patients with those of healthy subjects.
The study group consisted of newly diagnosed acute leukemia patients and the controls were matched for socioeconomic stauts and eating habits. The elements levels in the patient group were measured before treatment with an atomic absorption spectrophotometer. The selection criteria for the patients and controls were the lack of recent blood transfusion history and taking any medication with mineral supplement.
The acute leukemia group composed of 42 patients and there were 40 persons in the control group. There was no difference between the age of the two groups (p=0.239). Serum levels of Zn, Mg and Mn were significantly lower with acute leukemia than in controls (p<0.001, p=0.011, p<0.001, respectively), while Cu, Pb and Cd were significantly elevated (p=0.003, p<0.001, p<0.001, respectively). There were no significant differences regarding Co and Fe (p=0.323 and p=0.508, respectively)
In this study, we found levels of Zn, Mg and Mn to be lowered and of Cu, Pb and Cd to be elevated in patients with leukemia. Further studies are needed to clarify the role of these elements in pathogenesis of acute leukemia.
Full-text · Article · Jan 2011 · Asian Pacific journal of cancer prevention: APJCP
[Show abstract][Hide abstract] ABSTRACT: The purpose of the present study was to define the clinicopathological features and prognosis of esophageal cancer.
Between 2004 and 2009, 128 patients with esophageal cancer were enrolled in a retrospective database and divided into two groups on the basis of number positive lymph nodes with the cut-off as four.
The findings for 18 patients (14.0%) Group A were compared with those of 110 patients Group B. In the group A, there were significantly more women (12/6 vs. 54/56, P < 0.001). In both groups, the most frequent histological morphology was squamous cell carcinoma (83% and 75%, respectively), although the percentages were significantly different (P < 0.005). In the group A, lesions were more frequently located in the middle one-third of the esophagus than in the group B (61% vs. 28%, P < 0.001). Group A was more likely to be Stage IIa. Survival rates in group A patients at 5 years after resection were 15.8%, similar to those in group B patients (12.1%, difference not significant). Local lymph node metastases and microscopic residual tumor at the line of resection were also more prevalent in the young patients, but not to a statistically significant degree.
These findings suggested that the clinical and pathologic features of carcinomas of the esophagus in young patients do not significantly differ from those in older patients.
Preview · Article · Jan 2011 · Asian Pacific journal of cancer prevention: APJCP