Cansel Atinkaya

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.

The effect of CYP1A1, GSTT1 and GSTM1 polymorphisms on the risk of lung cancer A case–control study

Lung cancer, which is mainly affected by environmental factors, is a lethal malignancy. It is also important to investigate the effect of genetic factors on lung cancer aetiology. In this study, we aimed to investigate the distribution of CYP1A1*2C, GSTT1 and GSTM1 polymorphisms in Turkish lung cancer patients to determine whether any promoting effect of polymorphisms could cause development of lung cancer. For this purpose, genomic DNA samples obtained from peripheral blood of 128 patients with lung cancer and 122 healthy subjects were analyzed. Genotyping of polymorphic enzymes were carried out by polymerase chain reaction–restriction fragment length polymorphism methods. Although there were no significant differences between groups in terms of CYP1A1 polymorphism, the carriers of CYP1A1 Ile/Val genotype (odds ratio [OR] = 1.224, 95% confidence interval [CI]: 0.585–2.564) or CYP1A1 Val/Val genotype (OR = 3.058, 95% CI: 0.312–30.303) had an increased risk of lung cancer development. There was no statistical difference between groups in terms of both GSTT1 null genotype (OR = 1.114, 95% CI: 0.590–2.105) and GSTM1 null genotype (OR = 0.776, 95% CI: 0.466–1.290). This is the first case–control study investigating CYP1A1 Ile/Val, GSTT1 and GSTM1 polymorphisms in Turkish lung cancer patients. Although we suggest that other genes in addition to the proposed genes could play a role in lung cancer development, the results of our study will contribute to the possible associations between CYP1A1 Ile/Val, GSTT1 and GSTM1 gene polymorphism on the risk of lung cancer.

Lung Resection in an Elderly Patient with Limited Pulmonary Function; Case Report

Corresponding Author: Figen Türk, Erenler Mah. 211 Sk, No: 4/4, Yenişehir, Denizli, Türkiye. Phone: +90-258-373 98 34 · E-mail: figenturk@pau.edu.tr Özet Akciğer kanserinde anatomik rezeksiyon (lobektomi) en uygun cerrahi seçimdir. Kronik obstrüktif akciğer hastalığı akciğer kanserlerinde yaygın bir etiyolojik faktördür. Genellikle ileri yaştaki akciğer kanserli hastalarda kronik obstrüktif akciğer hastalığına bağlı solunum yetersizliği nedeniyle cerrahi rezeksiyondan kaçınılmakta ve özellikle FEV1 değeri 1 lt’nin altında olanlarda lobektomiden daha kısıtlı rezeksiyonlar önerilmektedir. Biz bu çalışmada akciğer kanserli ve FEV1 değeri 1 lt’nin altında olan ileri yaştaki bir hastaya yaptığımız lobektomi ameliyatı ile hastanın postoperatif sonuçlarını ilgili literatür eşliğinde tartıştık. Anahtar Kelimeler Akciğer Kanseri, Yaşlı, FEV1, Kronik Akciğer Hastalığı. Abstract Anatomical resection (lobectomy) is the best surgical choice for lung cancer.1 Chronic obstructive pulmonary disease is a common etiological factor for these cancers. Surgical resection is usually avoided in lung cancer patients at an advanced age because of respiratory insufficiency due to chronic obstructive pulmonary disease and resections that are more limited than lobectomy are recommended especially when the FEV1 value is below 1 L. We discuss the postoperative results of a lung cancer patient who underwent lobectomy despite being of advanced age and having an FEV1 value below 1 L.

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

The choice of invasive diagnostic techniques in advanced lung cancer.

BACKGROUND We retrospectively evaluated the invasive diagnostic techniques that were not suitable for transthoracic biopsy or bronchoscopy and the results of these techniques for advanced lung cancer cases. METHODS The files of patients operated at the Department of Thoracic Surgery, Faculty of Medicine, Pamukkale University for advanced lung cancer (stages III and IV) between 2006 and 2010 were retrospectively reviewed for the analysis of definite diagnostic methods. RESULTS The mean age of 59 patients who underwent invasive diagnostic techniques was 56.55 ± 9.42 years (32 to 75) and the female to male ratio was 1:4 (11 female:48 male). Mediastinoscopy was the most commonly used invasive technique with 20 patients (34%) while the second most common technique was video-assisted thoracoscopic surgery with 10 patients (17%). Thoracotomy was the most invasive diagnostic technique with four patients (6.5%). CONCLUSIONS Although it would be desirable to use noninvasive and minimally invasive diagnostic techniques in the diagnosis of lung cancers, we should not try to avoid using invasive diagnostic techniques in surgical practice in advanced lung cancers where other techniques may be inadequate.