Berkant Özpolat

Autologous blood pleurodesis in rats to elucidate the amounts of blood required for reliable and reproducible results.

BACKGROUND Pleurodesis is used in the treatment of spontaneous pneumothorax or refractory pleural effusions of different etiologies. Several agents have been employed, but many questions remain unanswered about their effectiveness and toxicity. Use of autologous blood pleurodesis in clinical practice has been described in the literature without any clear consensus regarding its efficacy. Experimental studies using this technique are limited to a single study in rabbits. We performed a prospective, randomized, observer-blinded, controlled study to evaluate the safety and efficacy of increasing doses of autologous blood pleurodesis in a novel rat model. MATERIALS AND METHODS Twenty-eight albino Wistar rats were divided into four groups. Groups 1, 2, and 3 were the study groups and group 4 was the control group, with seven animals in each group. Groups 1, 2, and 3 were given autologous blood, 1 mL/kg, 2 mL/kg, 3 mL/kg, respectively, and group 4 (control) was given only 2 mL/kg saline intrapleurally. The rats were sacrificed on postoperative day 30. The surfaces were graded by macroscopic (visible adhesion formation) and microscopic (inflammation and fibrosis) examination. RESULTS Macroscopically, group 2 and group 3 developed significantly more adhesions; 3 mL/kg autologous blood produced the most significant pleurodesis with generalized adhesions seen between visceral, parietal, and mediastinal pleura. Microscopic examination showed that all study groups developed an inflammatory response at the site of blood injection. There were no pathologic changes in ipsilateral and contralateral lung parenchyma. CONCLUSIONS Autologous blood at doses 2-3 mL/kg were shown to be effective to produce adhesions in 30 d, and the results were highly reproducible in all rats. We propose that the occasional negative results obtained in humans may be related to an insufficient amount of injected blood, as observed in our rat model.

Surgical Management of Chest Wall Tuberculosis

Objective: Tuberculosis remains one of the most fatal diseases in the world. Extrapulmonary tuberculosis increases in parallel fashion with the rise of incidence of pulmonary tuberculosis. Tuberculosis of the chest wall is rare. Methods: Our study retrospectively evaluated 10 patients with tuberculosis of the chest wall who were treated with surgery in addition to antituberculous chemotherapy in the last 8 years. Seven of the lesions were located on the anterior chest wall, and three of the lesions were on the lateral chest wall. Results: Surgical therapy consisted of evacuation of the cold abscess material from the cavities and wide débridement of the soft tissue planes in all patients. Partial rib resections were performed in six patients owing to costal or chondral involvement. Conclusions: Chest wall tuberculosis must be considered in the differential diagnosis of chest wall lesions, especially in endemic areas.

Elastofibroma dorsi: report of a case with diagnostic features.

Elastofibroma dorsi, named for its characteristic location, is a rarely seen benign soft tissue tumor mostly detected at the infrascapular region between the thoracic wall, the serratus anterior muscle, and the latissimus dorsi muscle. 1,2 The other locations of elastofibroma are the greater trochanter, deltoid muscle, ischial tuberosity, breast, foot, stomach, mediastinum, orbita, cornea, and oral mucosa. 3 The anatomic location, clinical symptoms, and typical radiologic features of elastofibroma dorsi may not easily distinguish this rare benign tumor from malignant soft tissue tumors. 4-6 Here we report preoperative diagnostic methods and surgical treatment of elastofibroma dorsi presenting with severe thoracic pain.

Treatment of Iatrogenic Tracheal Laceration with Cervical Mediastinotomy and Tube Drainage; a case report

Berkant Özpolat1, Cansel Atinkaya2, Nezih Özdemir3 1Department of Thoracic Surgery, Kırıkkale University Faculty of Medicine, Kırıkkale, 2Department of Thoracic Surgery, Pamukkale University Faculty of Medicine, Denizli, 3Department of Thoracic Surgery, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey. Servikal Mediastinotomi ve Tüp Drenajı ile Tedavi Edilen İatrojenik Trakea Yaralanması, Olgu Sunumu

Endoskopik Torakal Sempatektomide Prilokaine Bağlı Methemoglobinemi

Prilokain cok sik kullanilan bir lokal anestezik olup methemoglobinemiye neden olmaktadir. 22 yasinda palmar hiperhidrozis tanisi ile sedoanaljezi esliginde bilateral endoskopik torakal sempatektomi (ETS) yapilan kadin hastada prilokainin infiltrasyon anestezisi sonrasi 5. dakikada perioral ve tirnak yataklarinda siyanoz gelisti. 6 lt/dk maske O2 destegine ragmen direncli hipoksemi (SpO2: %80 ve PO2: 93 mmhg) gelisen hastada methemoglobinemi dusunulerek yogun bakim unitesine alindi. Kantitatif Glukoz-6-fosfat-dehidrogenaz (G6PD) enzim duzeyi, labaratuar degerleri ve akciger grafisi normal olan hastanin hidrasyonu %5 dekstroz ile saglandi. 4 lt/dk maske O2 ile oksijenizasyonu saglanan hastaya intravenoz (iv) kullanima uygun metilen mavisi bulunmadigindan iv askorbik asit infuzyonu baslandi. Takiplerinde arteryal kan gazlarinda pO2 ve methemoglobin (MetHb) duzeylerinde duzelme gorulen hastanin postoperatif 8. saatinde periferik ve perioral siyanozu yok oldu. MetHb duzeyi %4,5 ve pO2: 169 mmhg idi. Lokal anestezik kullanimi sonrasi aciklanamayan siyanoz ve hipoksemi gelismesine ragmen, farmakolojik antagonizma ve destekleyici medikal tedavilerin erken donemde uygulanmasi ile hastanin tedavisi saglandi.

Lung cancer and warthin"s tumor: a case report and review of the literature

Warthin’s tumor (WT) is a salivary gland neoplasm, which is also called as papillary cyst adenoma lymphomatosis. Herein, we present an uncommon coexistence of WT in an 80-year-old patient with PET/CT positive cervical lymph nodes, during the diagnostic workup of a pulmonary mass lesion. Histopathologic diagnosis of the lymph node was reported as Warthin tumor and transthoracic biopsy of the mass as non-small cell lung carcinoma. We want to emphasize that it would be essential to identify patients with WT as an association with lung cancer was suggested in the recent literature.

Deneysel hayvan çalışmalarında montelukast

Son yillarda sisteinil lokotrien (CysLT1) reseptor antagonisti, allerji ve astim tedavisinde kullanilan bir ilac olan montelukastin deneysel calismalarda siklikla kullanildigini gormekteyiz. Bu ve benzeri bircok calisma isiginda, ileride montelukastin farkli alanlarda kullanilacagini ongormek zor degil. Bunlarin basinda inflamatuar hastaliklarda kullanimi, graft versus host reaksiyonlarinin tedavisi ve ozellikle kanser tedavisi konusunda yapilacak calismalar basi cekecektir.

Cerrahi olarak tedavi edilen dev ve daha küçük boyuttaki akciğer kist hidatiklerinin karşılaştırmalı analizi

Amac: Bu calismanin amaci akcigerin dev kist hidatiklerinin daha kucuk boydaki hidatik kistlerle karsilastirilmasidir. Gerec ve Yontemler: Akciger kist hidatigi nedeniyle ameliyat edilen 62 hasta geriye dunuk olarak degerlendirildi. Hastalar dev kist hidatik (Grup A, n=23) ve daha kucuk capta olanlar (Grup B, n=39) olmak uzere iki gruba ayrildi. Gruplar yas, cinsiyet, semptomlar, kist yerlesimi ve sayisi, preoperative komplikasyonlar, uygulanan cerrahi girisim sekli, postoperative uzamis hava kacagi, gogus tupu alinma gunu, postoperative komplikasyonlar, hastanede kalis suresi, morbidite ve mortalite acisindan karsilastirildi. Bulgular : Yas, cinsiyet, kist yerlesim yeri acisindan anlamli fark saptanmadi ((P = 0.925, P = 0.293, P = 0.179). Grup A’da 21 (%91) vakada kistler tek , Grup B’de vakalarin yaklasik 1/3’unde birden fazla kist saptandi. Kistleri tek olmasi anlamli bulundu (P = 0.005). Grup A’da 13 (%56) vakada kistotomi + kapitonaj yapilirken, Grup B’de 8 (%20) vakada yapilmisti. Kistotomi + kapitonaj yontemi Grup B’de Grup A’ya gore anlamli olarak yuksekti. Uzamis hava kacagi Grup A’da 8 (%20), Grup B’de 2 (%5) vakada gozlendi. Ortalama gogus tupu cekilme gunu Grup A’da 4.57 ± 2.48 gun, Grup B’de 2.49 ± 1.63 gun ve hastanede kalis suresi Grup A’da 8.48 ± 3.39 gun ve Grup B’de 5.69 ± 1.80 gun olup her iki parametre istatistiksel olarak anlamliydi (P < 0.001 ve P < 0.001). Postoperatif komplikasyonlar Grup A’da iki, Grup B’de uc vakada gozlendi. Her iki grupta da mortalite yoktu. Sonuclar : Dev akciger kistlerinin soliter gorulme ihtimali fazla, ortalama gogus tupu cekilme ve hastanede kalis suresi uygulanan operasyondan bagimsiz olarak uzamistir. Kapitonajli veya kapitonajsiz yontemlerin uygulandigi her iki grupta kuratif cerrahi girisimlerin sonuclari mukemmeldir.

Nuss procedure and Factor VII deficiency: a case report.

A 19 year-old boy admitted with pain and discoloration on his chest wall 18 months after a Nuss procedure performed for pectus excavatum deformity. His physical examination revealed that this skin lesion was an ecchymosis. We diagnosed a very rare bleeding disorder due to Factor VII deficiency which is a recessively inherited coagulation disorder where even spontaneous bleedings may be seen. We aimed to discuss the management of the patient, if it had been diagnosed preoperatively and the preoperative preparation before the bar removal.

Clinical and Laboratory Evaluation of Anti-Microbial Efficacy of Photocatalysts

32 | Journal of Clinical and Analytical Medicine Berkant Ozpolat1, Tarik Cavusoglu2, Seyhan Yilmaz3, Unase Buyukkocak4, Serdar Gunaydin3 1 Gogus Cerrahisi AD, 2Plastik ve Rekonstruktif Cerrahi AD, 3Kalp Damar Cerrahisi AD, 4Anesteziyoloji ve Reanimasyon AD, Kirikkale Universitesi Tip Fakultesi, Kirikkale, Turkiye. Fotokatalizorler ve Anti-Mikrobiyal Etkinlik / Photocatalysts & Antimicrobial Efficacy Fotokatalizorlerin Anti-Mikrobiyal Etkinliginin Klinik ve Laboratuar Ortamda Degerlendirilmesi