Ahmet Basoglu

Pure Yolk-Sac Tumor of the Lung

Primary germ cell tumors of the chest often localize in the anterior mediastinal compartment. Such tumors originating from lungs and pleura are rare. Chest tomography revealed a mass in the middle lobe of the right lung in a 25-year-old man. A middle lobe medial segmentectomy was performed, and chemotherapy was applied postoperatively.

Bilateral neurogenic thoracic outlet syndrome

We report a case of bilateral neurogenic thoracic outlet syndrome (TOS). Electrophysiological examination suggested the presence of bilateral lower brachial plexus neuropathy. Radiography showed rudimentary bilateral cervical ribs. In the cases reported in the literature to date, the clinical findings are typically unilateral despite the common presence of bilateral bony abnormalities. Neurogenic TOS should be considered in young women, even if they present with bilateral symptoms, when they have occupations requiring strenuous activity of the upper limbs. Muscle Nerve 29: 147–150, 2004

Postoperative Lung Volume Change Depending on the Resected Lobe

OBJECTIVES The aim of this study was to evaluate the lung volume changes depending on the resected lobes. The changes were quantitatively evaluated using stereological methods on computed tomography images and by pulmonary function tests (PFTs). METHODS The study subjects included 30 patients who underwent lung resection. Of these, 26 patients underwent lung resection due to non-small cell lung cancer and 4 patients for benign reasons. Patients were classified into the following six groups according to the resected lobes and lungs: right lower lobectomy, right upper lobectomy, left lower lobectomy, left upper lobectomy, right pneumonectomy, and left pneumonectomy cases. All patients were evaluated with the PFT and computed thorax tomography (CTT), preoperatively and in the postoperative 3rd month. Volume changes due to resection were estimated on CTT scans using the Cavalieri principle of the stereological methods, and their relationships to the PFTs were evaluated. RESULTS Stereologically estimated data showed that the volume loss was 19.01% in upper lobectomy and 5.57% in lower lobectomy (p < 0.05). The highest volumetric increase of the contralateral lung and minor volume loss of the ipsilateral lung was observed in lower lobectomy. After right lower lobectomy, the highest postoperative volume increase was observed at the contralateral lung and the least volume loss in the remaining ipsilateral lung. In PFT, forced vital capacity (FVC) decreased to 3.07% after lower lobectomy whereas it decreased to 11.94% after upper lobectomy. FVC revealed that no significant change occurred after right lower lobectomy (p < 0.05). CONCLUSIONS Although the parenchyma resected in lower lobectomy is larger, the postoperative total lung volume reduction is less than that of upper lobectomy. After lower lobectomy, postoperative compensation is achieved specifically by the expansion of contralateral lung, together with the remaining ipsilateral lung.

Giant parenchymal bronchogenic cyst mimicking hydropneumothorax

Bronchogenic cysts are believed to result from abnormal budding of the tracheal diverticulum between the third and sixth weeks of gestation and consequently may be mediastinal or intrapulmonary in location. In the adult, bronchogenic cysts are frequently asymptomatic and present as an incidental finding in the chest roentgenogram. We present a patient with a giant parenchymal bronchogenic cyst that appeared as hydropneumothorax on chest radiograph and CT. The unusual cause and the interesting clinical course of asymptomatic bronchogenic cyst are described.

Comparison of the Protoscolocidal Effectiveness of Hypertonic Saline, Povidone—Iodine and Albendazole Solutions in an Experimental Lung Hydatid Cyst Model

Secondary hydatidosis is an important problem encountered during the surgical treatment of hydatid cysts. This study describes an experimental model of secondary hydatidosis by cyst inoculation, used to explore whether simultaneous inoculation of protoscolocidal agents could prevent secondary hydatidosis. Fertile cyst fluid was injected into the pleural space of rabbits alone (group 1, n = 8), and in combination with 2% albendazole solution (group 2, n = 8), 20% hypertonic saline (group 3, n = 8) or 10% povidone—iodine (group 4, n = 8). Computed tomography imaging of the thorax, indirect haemagglutination (IHA) titres and eosinophil counts were used to determine cyst development. After 16 months, three control rabbits had pneumothorax, seven had cysts and four had parenchymal nodules. Histopatho logical investigation of nodules revealed 87.5% cyst formation. Pleural thickening was observed in rabbits from all groups. Cyst formation rates, IHA titres and eosinophilia counts were higher in group 1 than in groups 2 – 4. This study demonstrated the experimental formation of secondary hydatidosis and found that topical protoscolocidal agents were beneficial in preventing cyst recurrence.

Effects of platelet-rich plasma on cartilage regeneration after costal cartilage resection: a stereological and histopathological study

Abstract Background: In cases of congenital chest wall deformities, it is important to maintain the flexibility of the chest wall after rib cartilage resection. In this study, we aimed to determine the regeneration capability of cartilage and the effects of platelet-rich plasma (PRP) on the regeneration process. Methods: A total of 16 four-week-old New Zealand rabbits were used in this study. In the 4th–5th right costal cartilages, the perichondrial sheaths were dissected and costal cartilages were excised. Then, the perichondrial sheaths were closed with absorbable material in the sham group (n = 8), and this was done after replacing PRP in the PRP group (n = 8). The left costal cartilages of the animals were used as controls. The volumes of the costal cartilages and their perichondrial sheaths were estimated using Cavalieri’s principle. In addition, the mean numerical densities of the chondroblasts and chondrocytes per square millimetre were estimated using unbiased counting frames. Results: In the PRP and sham groups, the volumes of the cartilages and perichondrial sheaths were higher than those of the control group (p < 0.05). The numerical densities of the chondroblasts and chondrocytes increased more in the PRP group than in the sham group (p < 0.05). Conclusions: Applying PRP after resection may provide better healing and faster regeneration of cartilage.

Endobronchial Hypertrophic Seromucous Salivary Gland: A Rare Bronchial Occlusion

A 41-year-old woman came to our clinics describing increased cough and shortness of breath. A chest roentgenogram revealed a loss of volume in her right lung. Computed tomography revealed a lesion at the level of the main carina, clogging the right main bronchus almost totally. The lesion underwent biopsy by use of flexible bronchoscopy. Histopathologic evaluation showed that the specimen was a hypertrophic seromucous salivary-type gland. Total excision of the mass was performed by bronchotomy through a right thoracotomy. We describe this case of a hypertrophic seromucous salivary gland in the tracheabronchial system.

Descending necrotizing mediastinitis associated with an infected dentigerous cyst

Descending necrotizing mediastinitis (DNM) is a rare condition in which an infection from the head and neck propagates into the mediastinum. The most common cause of DNM is odontogenic infection. DNM is spread by the fascial planes from the neck into the mediastinum and requires an aggressive surgical drainage through cervical and thoracic approaches. We report on a 67-year-old male patient, who had acute mediastinitis related to an infected dentigerous cyst in the left parasymphyseal region. A multidisciplinary team approach was used to treat the patient. The team consisted of thoracic surgeons, maxillofacial surgeons, and a radiologist. After the drainage of the mediastinum and pleural cavity, the cyst was enucleated. The patient was discharged at the 42nd day of hospitalization. The aim of this article is to present diagnosis, management, and follow-up of an infected dentigerous cyst that caused DNM.

Buerger's disease in eastern Anatolia

Thromboangiitis obliterans (TAO) is very frequent in eastern Anatolia. In a ten-year period 204 Buerger’s disease patients were diagnosed in Atatürk University Research Hospital. The patients were 18 to 45 years old (mean 28.4 years). Of these patients 185 were chronic smokers, 124 were from a lower socioeconomic level, and 137 were living in a cold climate. Cryoglobulin was positive in 48 patients.The diagnosis was established by physical examination, Doppler ultrasonography, angiography, and pathologic examination.Bilateral lumbar sympathectomy was done in 127 cases, unilateral lumbar sympathectomy in 49. Bilateral thoracic and lumbar sympathectomy was done in 10 cases. In 103 cases digital ulcers were detected. Ankle-brachial indexes increased by 0.1–0.2 by the fourth day after sympathectomies, and skin temperature increased by 2–3 °C.In 72 patients complete wound healing was achieved; 21 patients had one finger amputation, and 10 patients have undergone major amputations.

EMMPRIN and fascin expression in non-small cell lung carcinoma

Fascin and EMMPRIN (CD 147) have a demonstrated relationship with the invasion and progression of many tumors. The aim of this study was to analyze fascin and EMMPRIN expression in non-small cell lung carcinoma and their relationship with clinicopathologic features. Fascin and EMMPRIN expression levels were investigated via the immunohistochemistry of paraffin-embedded tissues of 64 patients with non-small cell lung carcinoma, including 46 squamous cell carcinoma and 18 adenocarcinoma patients. The patients were scored on the basis of staining extent and intensity, and were then assigned a combined score. Fascin expression was present in 44 of 46 (95.6%) patients with SCC and 16 of 18 (88.8%) patients with adenocarcinoma. There was a significant correlation between fascin expression and tumor stage in the SCC and adenocarcinoma groups. EMMPRIN expression was observed in all patients with SCC (46 of 46, 100%) and 16 of 18 (88.8%) patients with adenocarcinoma. There was significant correlation between EMMPRIN expression and both tumor stage and diameter in the SCC group, but not in the adenocarcinoma group. This study revealed that high levels of fascin and EMMPRIN expression may indicate the importance of their roles in the progression of non-small cell lung carcinoma and they could be used as prognostic marker for these tumors.