Makale Arama

In this article, 191 cases were presented who operated in The Thoracic and Cardiovascular Sur-gery Clinic, University of Selcuk between 1987 and 1994. 52.87% of them were male and 47.12% of were female. Most of the patients were 11-20 years of age. 99 of cystes (51.83%) were in right lung, 84 (43.97%) were in left lung and 8(04.17%) of them were in both lungs. Median sternotomy was per-formed in 5 cases, segmentectomy in 6 cases, wedge resection in 7 cases, lohectomy in 9 cases, cystotomy and capitonage in 159 cases, decortication in 10 cases and cystectomy in 4 cases. 13 liver cystes and one spleen cyste were excised via trans-diaphragmatic approach. Empyerna was seen in 4 cases and succesfully treated. Only one case died on respiratory failure. Relapse was not seen in any case.

Lung cancer is the most common among cause of cancer deaths in worldwide. NSCLC represent between 80% to 85% of all the diagnosed lung cancers cases. Systemic chemotherapy for patients with NSCLC has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study analyzed prognostic factors for survival in NSCLC patients. We retrospectively reviewed 741 NSCLC patients between 2000 and 2012. Ten potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors. Among the 10 variables of univariate analysis, three variables were identified to have prognostic significance: performans status (PS), diabetes mellitus (DM) and stage. Multivariate analysis included the 3 prognostic significance factors in univariate analysis. Multivariate analysis by Cox proportional hazard model showed that PS was considered independent prognostic factors for survival, as were DM and stage. In conclusion, PS, DM and stage were identified as important prognostic factors in NSCLC patients. These findings may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

Objective: To evaluate the chest roentgenogram and CT findings of 63 patients with pulmonary hydatid disease. Methods: Sixty-three (27 female and 36 male, aged between 3 and 76 years) patients with surgically proven pulmonary hydatid cysts were included to the study. Chest roentgenogram and thorax CT were obtained from all the patients. Radiological features (number, localization, diameter, internal architecture) were determined. Results: On CT examination, 107 cysts were determined but on 78 of 107 cysts were detected on chest roentgenogram. Single cysts were seen in 36 patients, while multiple cysts were seen in 27 on CT. Eighteen cysts were larger than 10 cm in diameter. CT scan showed crescent sign (3 patients), water lily sign (9 patients), air-fluid level (11 patients), dry cyst sign (8 patients), and homogenous shadow (46 patients). In addition, atelectasis (n 17), pleural effusion (n 29), and pericystic infiltration (n 38) were also seen on CT. On the other hand, 58 cysts were homogenous and 20 cysts were rüptüred on chest roentgenogram. Conclusion: Although chest roentgenogram is helpful for diagnosis of pulmonary hydatid disease, CT examination must be done to evaluation nature and localization of cysts.

In this study, the protective action of the •he-lating agent ethylenediamine tetraac:etic acid di-sodium (Na2 EDTA) against ouabain intoxication in healthy mice was investigated_ Although Na, EDTA, at the concentrations tested (10. 20. 40 and 80 mgl kg) had no effects alone. it abolished the toxic elfect induced hy 5 mglkg ouabain at the doges of 40 ad 80 mgikg. The toxic elfect of 15mgikg ouabain was also significantly inhihited hy the highest dose of Nal EDTA (80 mglkg). These results suggest that Na2 EDTA has protective action against ouabain to-xicitiy due ta chelation of calcium.

Eosinophilic pulmonary diseases (EPD) are defined as a group of diseases characterized by the in crease of eosinophils in the air way and/or lung tissue. While a part of the sedis orders mainly affects the pulmonary, others show systemic in volvement. Chronical eosinophilic pneumonia (CEP) should be kept in mind in the existence of subacute or chronic respiratory and general symptoms, alveoler and/or bloode osinophilia and peripheral pulmonary in filtrates on chest radiography. A 53-year-old male patient was admitted to our clinic with on going complaints of cough, occasional fever and malaise for six months. When two-sided apical, subapical and the infiltration around hiluses were detected on chest x-ray, the case was hospitalized with the prediagnosis of pulmonary tuberculosis. Eosinophilia in hemogram, bilateral infiltrative lesions with irregular contours and bilateral cystic bronc hiectasis foci were detected on high resolution computed tomography (HRCT). Bronchoscopy revealed purulent secretions and thick mucous in hibations. No specific etiologic cause was defined in the etiology, and the case wase valuated as CEP. Due to unusual bronchoscopic and radiological findings, the case was presented and discussed.

The aim of our study was to determine serum asymmetric dimethylarginine (ADMA), nitric oxide (NO) and arginine levels in patients with acute attack, stable and cor pulmonale Chronic Obstuctive Pulmonary disease (COPD). Twenty five acute attack of COPD, twenty five stable of COPD, twenty five cor pulmonale subjects partipicated in this study. To be selected patients had to have no other diseases. The control group was formed by twenty five appearentely healthy people. ADMA and arginine levels were measured by high performance liquid chromatoghraphy with fluorecence detection. Serum nitrite/nitrate concentrations were determined using a commercial colorimetric assay. Patients of acute (p

Aim: The aim of this study is to evaluate the outcomes of the patients with uncompleted treatment of TB, their demographical properties and to determine the reasons. Material and Method: This descriptive study was carried out throughout Konya in 2001. Total 1979 cases undergoing TB treatment were included in the study. It was established that 164 (%8.3) of the cases taking TB treatment had given up treatment too early. All these cases were interviewed face to face at their addresses registered in their files. This interview included clinical irregation, PPT application, pulmonary X-ray exemination and collection of sputum for ARB. Results: The mean age of the tuberculosis patients was 36.8±16.5 yrs in male and 38.6±19.1 yrs in female (P>0.05). Among the 1979 cases taking tbc treatment, 8.3% gave up the treatment. This rate was 21.6% among the cases whose treatment began in hospital, and 4.5% among the cases of dispensaries. 40.6 % of the patients was illiterate. 38.7 % of them did not have social security. The relatives of 39.4 % cases had a tuberculosis history. There was accompanying illness in 36.8 % of the patients. 61.9 % of the males and 14.3% of the females were smokers. Conclusion: We believe that general economical development, better education level, regular administration and follow-up systems and efforts to provide a better communication with patients may positively affect the results of efforts against the tuberculosis.

Obesity surgery is a highly effective method on ensuring a maintained weight loss. Following the obesity surgeries, while there are complications specific to type of the surgery, early or late complications also can be seen. In our study, we aim to present the determined complications during or post surgery on patients who were conducted bariatric surgery due to morbid obesity.Bariatric surgery was conducted on a total of 361 patients. Of these patients, 207 (57.3%) laparoscopic sleeve gastrectomy (LSG), 38 (10.5%) laparoscopic Roux-n-Y gastric bypass (LRYGB), 32 (8.8%) Rouxn-Y gastric bypass (RYGB), 32 (8.8%) mini gastric bypass (MGB), 28 (7.7%) laparoscopic mini gastric bypass (LMGB), 21 (5.8%) sleeve gastrectomy (SG), 2 (0.5%) vertical banded gastroplasty (VBG) and 1 (0.2%) intragastric balloon placement procedures were applied. Anastomotic leak was determined on 2 patients (0.5%) with Roux-n-Y gastric bypass. On 1 patient with SG conducted, a leak through stapler route has occurred. On 1 patient evisceration, on 1 patient a spleen injury during the surgery, on 44 patient (12.1%) surgical site infection were detected. 91% of these patients with surgical site infection had diabetes mellitus. While on patients with laparoscopic bariatric surgery the ratio of surgical site infection was 6.8%, in open surgery this ratio was increased up to 29.4%. Ileus, pulmonary embolism and DVT were developed in 9 (2.4%), 3, (0.8%) pulmonary and 8 (2.2%) patients, respectively. On super obese 2 patients mortality was occurred due to postoperative lung insufficiency. With bariatric surgery, regardless of the surgery technic used there is a possibility of morbidity. Consequently, it must be careful for selecting a morbid obese patient and during the treatment in terms of complications.

We evaluated retrospectively 230 new pulmonary tuberculosis from 395 tuberculosis patient that were applied to Konya Mümtaz Koru Dispansery between years 1998 and 2001. 123 patients (53.5%) was smear (+) and 24 (10.4%) was smear (-). 83 (36.1%) patients had been diagnosed without suputum test. The percentages of suputum test and bacteriological diagnosis were 27% and 25.3% in 1998, 70% and 51.1% in 1999, 83.3% and 77.8% in 2000, 96% and 74% in 2001 respectively. 57 (46.34%) of the 123 ARB (+) cases was treated as cure and 55 (44.71%) as completion of the treatment. Our total treatment success and cure rates were 85% and 5% in 1998, 91.6% and 50% in 1999, 95.2% and 40.5% in 2000, 89.1% and 72.9% in 2001 respectively. %54.4 of pulmonary tuberculosis cases were 15-34 years old. Although the rate of the application of patients to the dispansery were low between 1998 and 2001 the rate of bacteriolojical diagnosis was increased throughout the years but our cure rates did not reach to the suggecful level of WHO.

68-year –old male patient was being accepted from a special clinic to us with a presumed diagnosis of right upper lobe tumor .The patient has a respiratory distress,weight loss,palpitations. Mediastinal enlargement was seen in the upper right chest film. Thoracic computed tomography was noticed a mass nearly 5x7x3 size which connection with cervical area and deviated from outside the trachea,compressing right lobe anterobasal segment . Thyroid hormone tests were performed and showed hyperthyroidism .The patient took anthyroid agent only 1 month and then taken operation elective conditions .We performed operation with a general surgery cervical insision after parsial median sternotomy. Total troidectomy was performed, after the realised cervical troid upper side of neck and then tracheal , borned from intrathoracic component preserved vascular and paratroid structure.The specimen nearly 5x7x3 cm which called noduler collaidal guatr from the pathology .The patient was discharged without any problem by giving thyroid hormone.

Hiccup is the sudden onset of erratic diaphragmatic and intercostal muscle contraction and followed by immediate laryngeal closure. Hiccup is usually a self-limited disorder; however when it is prolonged beyond 48 hours, it is considered persistent whereas longer than 2 months are called intractable. The pharmaco therapy of hiccup includes chlorpromazine, gabapentin, baclofen,serotonergic agonists and lidocain. Non-pharmacological approaches are nerve blockade and acupuncture. We report 3 cases presenting with persistent hiccup in brain stem lesions and treated with baclofen.

Aim: It was aimed to investigate  the relationship of disease clinical stage between the maximum diameter of primer lesion (LEGÇ), maximum of standardized uptake value (SUVmax), mean of standardized uptake value (SUVmean), tumor volüme (TV) and total lesion glycolysis (TLG) values derived from positron emission tomography/computed tomography (PET/CT) images.

Method: The information of 130 lung cancer patients diagnosed histopathologically between 01.01.2012 and 31.12.2014 in Necmettin Erbakan University Nuclear Medicine Department of Meram Medical Faculty scanned for PET-CT for lung cancer diagnosis and staging,  were included in this study. The values of the maximum diameter of primer lesion, SUVmax, SUVmean, TLG and MTV derived from PET-CT scanning and their histopathological subtypes, other clinical and radyological information of patients were noted. The non-small cell lung cancer patients were graded according to tumor diameter, nodal and involvement metastasis (TNM) staging system using clinical information, PET-CT and other radyological test results if any. On the other hand, the small cell carcinoma diagnosed were categorised as limited or extensive stage.

Findings: In this study, the mean age of 118 men and 12 women,  totally 130 patients, was evaluated  63,46 ±9,96 ( range 40-87 age ). The patients were classified as 106 non-small cell lung Cancer (NSCLC) (81.5%) ve 24 small cell lung cancer (SCLC) (18.5%).  The  histopathologically diagnosed NSCLC patients were consists of  62 squamous cell cancers, 39 adeno cancers, and 5  other types (3 carcinoid tumors, 1 large cell cancer and 1 sarcomatoid tumor). 

Results: In our study, it was observed that there was no significant relationship between the maximum diameter of the lesion, SUVmax, SUVmean, MTV and TLG values among SCLC and NSCLC patients. Additionally, it was also found that there was no correlation between these parameters and the SCLC stage.  The maximum diameter of the lesion, SUVmax, SUVmean, MTV and TLG parameters were related with stage.

Conclusion: Higher SUVmax, SUVmean, TV, and TLG values of the primary tumor were determined to predict the more advanced clinical stage in NSCLC. This relationship between metabolic parameters and the clinical stage suggest that PET / CT may be valuable in terms of providing prognostic information in NSCLC.

Purpose: In the case of the skeletal muscie metastasis of lung cancer the authors report radiographic, CT scan and MRI findings of painful masses in the femoral regions. Muscle biopsy revealed extensive infiltration of the muscle with carcinoma cells. Case: A 68 year-old man presented with a large cavitary lesion with thickened wall in the left hilus on radiogrraphy and CT scan. The diagnosis of the lung cancer was made by bronchoalveolar lavage. The radiograph did not Show any soft tissue mass, except periosteal reaction. MRI showed a tumoral mass in the right quadriceps muscle with signal intensity slightly lower on T1-weighted and higher in T2-weighted images than surrounding muscle tissue.Needle biopsy revealed metastatic squamous cell carcinoma. The patient died six month later. Conclusion: MRI is more useful technique than the other methods for determination of the localization, the relationship of the surrounding tissues and the manifestations of metastatic masses on the skeletal muscle due to malign tumor of the lung.

A series of 460 cases of hydatid cyst of the lung has been studied. Preoperative diagnosis has been made radiologically in 90<,-, of the cases. In 395 cases, cystotomy has been performed with subsequent capitonnage, while, wedge resection has been performed in 27 cases, with lobectomy in 15 cases and segment resection in 23 cases. Following a careful he-rnorrhage control, two drains have been placed in the thorax and the thoracic cavity has been closed. Recurrence occured in two cases (0.43 %), three cases resulted in exitus (0.65 %); no recurrence has been encountered in other cases as revealed by post-operative follow-up cheks within a period of theree years after operation.

Aim: Small cell lung cancer (SCLC) is associated with an aggressive course and short survival. Conventional chemotherapy (CT) is the mainstay of SCLC treatment. However, the majority of information on chemotherapy (CT), as well as information on demographic data of patients, is based on studies from several decades ago. In this study, we aimed to determine the current demographic and clinical characteristics of patients with SCLC and to determine their responses to the treatments.

Patients and methods: This was a retrospective, cross-sectional, cohort study. Definitions of survival were overall survival (TOS) and survival after metastasis (MOS). TOS was calculated as the time from the diagnosis to the date of death or last visit. MOS was calculated as the time from the diagnosis of metastasis to the date of death or last visit.

Results: The data of 161 patients were analyzed. Response rates obtained with 1st line CT, 2nd line CT, and 3rd line CT were 72.2%, 43.3%, and 40.4%, respectively. The median TOS and median MOS were calculated as 15.7 months (0.03-106.97) and 13.79 months (0.03-79.54), respectively. Although they were metastatic, ten patients had never received first-line CT, and the median MOS was 1.88 months and 14.62 months, respectively, in those who did not receive CT and received CT. Twenty-one (18.9%) of the 111 patients who needed second-line treatment did not receive CT, and the median MOS was 8.39 months and 18.45 months, respectively, in those who did not receive CT and received CT. Eighteen of the 65 patients (27.7%) who required the third-line treatment did not receive CT, and the median MOS was found to be 15.36 months and 23.86 months, respectively, in those who did not receive CT and received CT. The presence of metastatic disease at the time of diagnosis and refusal of treatment were statistically significant parameters affecting the median TOS. And, poor performance status and refusal of treatment were statistically significant parameters parameters affecting the median MOS.

Conclusions: In this study, it was confirmed that early diagnosis of SCLC was associated with a survival advantage. It was shown that the patients who received and were able to tolerate the treatment had obtained a survival advantage, regardless of the disease phase.

In The Patients With Lung Cancer It is well known that lung cancer is one of the main causes of the paraneoplastic neuropathy syn-dromes. Although the lung cancer has remote effect on peripheral nerves, whether it affects central neu-ronal pathways is not clear. In this study visual, auditory and somatosen-soriel evoked evoked potentials (VEP,BAEP,SEP re-spectively) are recorded in the 28 patients with lung cancer in whom no cerebral metastase were found-ed. Nerve conduction study showed sensory neurop-athy in 7 patients (25%). VEP latencies were path-ologically delayed in 4 patients (19.'4%). Frequency in the abnormal delay of SEP (N19 and 131) is also 19.4%. BAEP could not he elicited in 5 patients (17.24%). We concluded that central neuronal path-ways are also he influenced by remote effect of the lung cancer. However its central effect is not so _fre-quent as peripheral one.

There is no consensus in approach to patients suffered from gunshot injuries since they almost die in scene or on the way to the emegency room. Manegement of the patients with gunshot bullet wounds of thorax is different even among thoracic surgeons. Complication of penetrating chest trauma due to gunshot injuries can occur within days, months even within years. A patient was admitted to the thoracic surgery clinic in bad condition. Foreign body was detected in chest X-ray patient. He had been considered stable and non complicated and discharged from hospital after a penetating gunshot injury of thorax two years ago. We report late presentation of empyema as a late complication of bullet after two years of injury.

Skeletal muscle metastasis from non-small-cell lung cancer (NSCLC) is a rare event and the optimal treatment strategy is still unknown. Herein we report a case with biceps metastasis from NSCLC. A 50-year-old man with a distant biceps metastasis due to NSCLC is presented. One month after chemo-radiotherapy and adjuvant chemotherapy the patient was readmitted with a painful mass located on the right biceps brachii muscle. A biopsy of the painful mass disclosed the muscle metastasis pulmonary adenocarcinoma. The patient was treated with palliative radiotherapy and systemic chemotherapy was planned. At the end of the palliative radiotherapy his pain was disappeared. Two months later (18 months after the diagnosis) the patient died of respiratory failure. Palliative radiotherapy may be a good treatment option for patient with muscle metastasis from NSCLC.

/Ve observed patients with Herpes Zoster for the malignant diseases who came to dermatology elinle in the last five years. Of the 213 patients, in 12 ( % 5.68) we found malignant diseases such as pulmonary, hepatic, ovary, bladder cancers, squamous celi carcinoma, chronic lymphositic leukemia and non- hodgkin lymphoma. We suggest that, patients with Herpes Zoster must be searehed for malignant diseases, but it doesn ’ t mean that Herpes Zoster is a cancer marker.

There is a limited effect in standard medical treatment of emphysema for quality of life and survival of patients. Symptoms of most of the patients progressive rapidly. It is hoped that symptomatic remission may be occured on selected patients by surgical treatment(1). Simultaneously two surgical operations which one of alternative treatment methods, protect the patients from two different major surgical procedures which are performed at different times, and reduce the cost of treatment. In this article we present a successful bulla resection case that has done with stapler and combined with coronary artery surgery.

The diagnosis of a congenital diaphragmatic hernia (CDH) is often made on a prenatal ultrasound examination at routine obstetric care. After birth, the spectrum of respiratory symptoms in an infant with a CDH is determined by the degree of pulmonary hypoplasia. The most affected infants develop respiratory distress within the first 24 hours of life. However, some of the infants with this defect present later, depending to the severity of the defect. Defects are more common on the left side, and it has been reported that patients with right-sided defects have a worse prognosis than those with leftsided defects. Here, we reported a case of a newborn infant with respiratory distress developed on the second weeks of life, and which diagnosed with right-sided diaphragmatic hernia containing part of the right lobe of the liver, bowel and the kidney.

Antineutrophil cytoplasmic autoantibody (ANCA) associated small vessel vasculitis constitutes a group of life-threatening diseases and renal involvement is its most severe and common manifestation. Microscopic polyangiitis (MPA) is a rare form of such vasculitis in children characterized by pulmonary-renal syndrome with pauci-immune rapidly progressive glomerulonephritis. A 9-yearold boy was admitted to our hospital because of rash, arthralgia and dark urine. Urine analyses showed hematuria and proteinuria. Blood examination revealed anemia, renal failure and positive p-ANCA. A chest CT revealed diffuse infitration. The renal biopsy demonstrated crescentic glomerulonephritis, immunofluorescent examination was negative. He was diagnosed MPA. High-dose methylprednisolone and high-dose cyclophosphamide therapy improved all of the lung infltrates and renal function.

Pulmonary embolism(PE) is a serious disease which is one of the most important reason of cardiovascular mortality. In spite of the fact that electrocardography(ECG) has a limited effect on the diagnosis and determination of the prognosis of PE, it is an essential method for clinically differentiating PE from other diseases that might be confused with PE, such as myocardial infarction(MI) .The aim of this case report presentation is to discuss whether this stuation might be a marker on determination of the prognosis.and the fact that PE could mimic the ECG findings of ST elevation myocardial infarction even though it is rare. Fifty six years old patient with acute renal failure and disorder of liver dysfunction, who had been treating in intensive care unit of internal medicine department, complained about chest pain and shortness of breath occuring on second day of his admission to the hospital. The patient was taken from cardiology department with anteroseptal MI prediagnosis after evaulation of the ECG demonstrating about 4 mm ST elevation in V1-V4 precordial derivations. Coronary angiography was performed to the patient being thought to whom primary percutaneous coronary intervention might be neccessary and there was not any lesion determined in epicardial coronary arteries. The parameters obtained from transthoracic echocardiographic evaulation of the patient was corcordant with the diagnosis of PE. It was understood from the imaging reports performed previously that trombus in vena cava inferior had been detected. The patient had cardiac arrest and died while he was being prepared for the pulmonary embolectomy operation after diagnosing of PE. The aspect which made our case report more attractive is that there were only various case reports published about PE in literature, which indicateST elevationmimicing anterior myocardial infartion. It is thought that this situation might be observed in PE and might guide for determination of the prognosis as well when this case report is evaulated together with the other ones.

Purpose : This study compares the organ doses at risk by using the Eclipse treatment planning system for two common total body irradiation techniques (TBI) at extended source skin distance.

Material and Methods: 3D treatment plans with AP-PA (anteroposterior) technique were created retrospectively for 20 patients treated bilateral TBI. For each patient, the whole body, kidneys, lungs, thyroid and liver were contoured to create (DVH) dose volume histograms and examine 3D dose volume distributions. The mean doses of thyroid, lung, kidney, liver, whole body and treatment volumes and the maximum doses of 2% volumes (D2) were calculated from the dose volume histogram and transferred to the SPSS file. The non-parametric Wilcoxon test was used to compare the dose values for two techniques.

Results: Thyroid gland mean doses were significantly lower in lateral technique (11.98 and 12.64 Gy, p = 0.21). It was observed no statistically dose difference between the two techniques in terms of lung doses. Since, the lungs were protected by lead blocks in both of two techniques. The mean doses of liver and kidney were lower in the lateral TBI technique (p = 0.002 and p = 0.004, respectively). D₂ doses of liver were lower in AP-PA planning technique (p = 0.032). In comparison of the hot points between the two techniques, the lateral position was significantly superior (p <0.0001).

Conclusions: In present study, it was observed that the bilateral position was superior to the AP-PA position in order to prevent the hot spots. In the AP-PA position, it is more difficult to tolerate the body irregularities. Additionally, when comparing the dose distributions of the organs (liver, kidney, thyroid), it was seen that the results were statistically better in the lateral position. The lateral position provides an advantage in terms of more homogenous dose distribution and better quality planning.

Aerosol glucocorticoids and bronchodilators are highly effective in the treatment of obstructive lung disease. Treatment failures can often be attributed to poor patient compliance or incorrect use of the inhaler. IVe surveyed the patients with chronic We showed that training in application associated with demonstration and subsequent exercise reduces the error ratio to a tolerable level in COPD patients.obstructive pulmonary disease (COPD) to assess their knovvledge of and ability to use four widely used inhaler devices; metered-dose inhaler, turbuhaler and diskus. Fourteen paitents with COPD were asked to demonstrate the use of each device using placebo inhalers. The inhalation technique was assessed in ten steps. Correct use was considered if 10 points were obtained. This study showed a high incidence of incorrect usage of inhalers amongst COPD patients.

Aim: We report the management of one patient with rheumatoid arthritis developed pyopneumothorax. Case Report: Fifty seven-year old male patient with rheumatoid arthritis fors ix years was admitted to our emergency unit with complaints of fever, dyspnea on exercise, coughing, continuing for last 10 days. Right hydropneumothorax was observed in chest radiography. Thoracentesis was performed initially. The patient was treated by chest tube drainage. The thoracotomy was planned because of the lungs were not expansed by the performed treatment. The thicked pleura was removed at the operation. Conclusion: Pathological findings demonstrated rheumatoid nodules.

Aim: Sarcoidosis is a multifactorial disease with unknown aetiology and characterized by non-caseous granulomatous inflammation. The pathogenesis of sarcoidosis is defined as inflammation and autoimmune activation. Here, we aimed to evaluate plasma clusterin (CLU) and α-klotho levels in those with sarcoidosis.                                        

Patients and methods: Forty patients with sarcoidosis (mean age: 52.10±12.60 years; 12 males, 28 females) and 40 healthy volunteers (mean age: 37.40±18.20 years; 12 males, 28 females) were enrolled into the study. Blood samples were drawn from both groups, and plasma CLU and α-klotho levels were investigated by enzyme-linked immunosorbent assay (ELISA) technique.                                                               

Results: Patients with sarcoidosis had significantly higher plasma CLU levels (309.73±40.68 ng/mL), compared with healthy controls (117.86±102.03 ng/mL) (p=0.005). The plasma levels of α-klotho were measured as 5.34±7.30 in the sarcoidosis patients and 7.21±9.84 ng/mL in the controls. A minimal decrease was observed, but there was no statistically significant difference (p=0.338). The hemoglobin levels of sarcoidosis patients were decreased, when compared with the control group (12.93±1.02 g/dL vs 14.06±1.50 g/dL) (p=0.012).                                                                    

Conclusion: We concluded that sarcoidosis is associated with high levels of CLU. Plasma CLU may be a potential biomarker of sarcoidosis. Based on literature and to the best of our knowledge, this is the first study to provide insight in the determination of plasma levels of CLU and α-klotho in sarcoidosis. Further and comprehensive investigations are needed to clarify the entity.

Background: Electromagnetlc fields (EME) are the most important environment problems that effect the public health in our century. Increasing incidence of coronary heart disease, leukemia, lymphoma, and Alzheimer in the patients who are effected from magnetic fields, are revealing that these sources can not be used unlimitedly. İn this study, we would like to investigate the effect of hairdryer on the rats. Materials and methods: İn this study, 200-250 gr weighted 29 male rats vvere used. 15 of them were control group, and 14 vvere faced with EMF. A BKK 1161 SK hairdryer was used as the magnetic field source. This machine had 600 VVatt (W) power, 220 V - 50 Hz resistance, and a mean magnetic field counted 100-150 mG. The distance betvveen the subjects and the machine was 20-25 cm. EMF was performed on them for 3 days of each week, and 5 minutes of each day, and it was lasted after 3 months with a total period of 205 minutes. At the end the malondialdehid (MDA) levels in the subjects sera vvere calculated, and they vvere sacrificed and their cerebrum, thymus, lungs, heart and great vessels, liver, kidneys, and spleen vvere taken to histopathologic examination under light microscope. Results: İt was obviously observed that the EMF in 50 Hz freguency increases the mononuclear celi infiltration in the viscera; especially, it was estimated that EMF causes alveolar destruction in the lungs, tubuler degeneration in the kidneys, glial proliferation in the cerebrum, fibrosis in the liver, and adventitial mononuclear celi infiltration in the great vessels in 3 months, vvhich is thought to be a very short period. Statistically, the subendothelial dissection in the great vessels was not found significant, hovvever, this was thought to be an important finding. The serum MDA levels of EMF group vvas increased, but statistically, this was not significant. Conclusion: We concluded that EMF causes an increase in the production of free oxygene radicals, and in the late-term this results with various diseases including cancers and atherosclerotic dişe ases.

A retrospective study was performed to investigate the mortality among the patients hospitalized in department of chest diseases Dicle University medical school clinic. The patients passed out in this clinic in the period from January 2004 to May 2009 were evaluated. It was determined that totally 4417 patients were hospitalized (8892 hospitalization) in this period and 384 (8.6%) of them resulted in death. The mean age of the patients was 66.8±15.3 and 92 (33%) were women and 187 (67%) were men. The principal causes of their mortality were pneumonia in 92 patients (33.1%), chronic obstructive pulmonary disease (COPD) in 87 (31.2%) patients, pulmonary cancer in 52 (18.6%) patients, tuberculosis (TB) in 18 (6.5%) patients, pulmonary thromboembolism (PE) in 18 (6.5%) patients and another diseases in 12 (4,2%). When the accompanying diseases were evaluated, no additional diseases were determined in 130 (46.6%) patients; 41 patients (14.7%) had cardiac disorders, 22 patients (7.9%) had cancers outside the lungs, 18 patients (6.5%) had cor pulmonale, 17 patients (6.1%) had neurologic disorders, 15 patients (5.4%) had renal diseases, 10 patients (3.6%) had diabetes mellitus (DM), 9 patients (3.1%) had TB and 17 patients (6.1) had unclassified disorders. In conclusion, we think that the knowledge about their mortality rates and the causes of mortality is useful for every clinic for their approach to the patients and considering the accompanying diseases is helpful to decrease the mortality

Obesity hypoventilation syndrome (OHS) is a reason of hypercapnic respiratory failure (HRF) and early death. In this study, the laboratory and clinical characteristics of 29 female patients who did not have obstructive pulmonary disease and admitted to pulmonary medicine intensive care unit due to HRF were evaluated. The mean age of the patients was 63.6±17.3 and polysomnography was applied to all of them. The mean body mass index (BMI) of the cases was 41.7±9.4. According o all night polysomnography the mean apnea-hypopnea index was 38.8±29.1, arousal index was 34.6±26.1 and the mean night saturation was 66.5±8.8. BIPAP/CPAP was given to 23 of 29 cases to use at home. The BIPAP titration of the patients demonstrated a mean IPAP of 15.1±1.3 cmH2 O and a mean EPAP pressure of 8.25±1.6 cmH2 O. In conclusion, it was observed that NIV is a therapy that decreases the morbidity and mortality in cases with OSH.

Demonstrating the imaging findings of asymptomatic giant thymolipoma mimicking cardiomegaly is aimed. A paracardiac mass was detected with 32-year-old male patient afterwards demonstration of cardiomegaly on a posterior-anterior (PA) chest x-ray examination taken for a routine control. Computed tomography (CT) showed a mass, localized in the anterior mediastinum, with smooth margins, showing no significant invasion of adjacent structures, and including fat density with fibrous component. The diagnosis was reported as thymolipoma histopathologically after transthoracic biopsy. On a preoperative magnetic resonance (MR) examination, taken for detailing the limits of the lesion, the mass showed hyperintensity on both T1 and T2 weighted images, and suppression on fat saturated T2 weighted images. No invasion of adjacent structures was detected. A thymolipoma may reach a large size without symptoms due to its great pliability. It can mimic cardiomegaly on x-ray images. Adipose tissue on CT is helpful in the diagnosis. MRI gives valuable information in determining the exact boundaries of the lesion.

Objective: The aim was to review the hormonal status, treatment and histopathological diagnosis of patients admitted to our endocrinology outpatient clinic with the diagnosis of adrenal incidentaloma.

Material and Methods:Between 2015-2018, 217 patients with adrenal incidentaloma who were admitted to the endocrinology outpatient clinic were included in the study. 1 mg overnight dexamethasone suppression test (DST), 24 hour urine free cortisol, 24-hour urine methanephrine and normetanephrine levels were evaluated in all patients.Patients who also have hypertension or hypokalemiawere screened for the plasma aldosterone/renin activity ratio. CT or MRI imaging properties of adrenal incidentalomas were screened.

Results: In the evaluation of cases; 180 (83%) of the masses were evaluated as non-functional and 37 (17%) as functional. Of the 37 patients evaluated as having functional adrenal mass; 10 (4.6%) pheochromocytoma, 5 (2.3%) Cushing's syndrome, 9 (4.1%) subclinical Cushing’s syndrome and 13 (6%) primary hyperaldesteronism were detected. In 180 patients who were evaluated as having non-functional adrenal mass; metastatic disease in 7 (3 non-small cell lung cancer, 1 breast cancer, 1 prostate carcinoma and 2 unknown primary cancer), myelolipoma in 4, ganglioneuroma in 1, hydatid cyst in 1, adrenocortical carcinoma in 2 patients were detected.

Conclusion: According to the results of this study, it is not uncommon for adrenal incidentalomas to be functional. It may be malignant in some cases. For this reason, adrenal incidentaloma is a condition that should be examined both in terms of
functionality and malignancy potential.

Organizing pneumonia (OP) is characterized histopathology cally by tufts of fibroblasts and immature collagen filling of respiratory bronchioles and alveoli. Symptoms are usually nonspecific and include cough and dyspnea. Radiograph cally, OP frequently manifests as patchy bilateral infiltrates that can be relapsing and migratory. Cryptogenic organizing pneumonia (COP) may be defined as having non-specific symptoms which can ultimately be described as a subset of the OP that cannot be attributed to any reason. Forty-nine-year-old female patient admitted with the complaints of 2 year exertional dyspnea and 20 day dry cough. The patient was diagnosed of pneumonia and prescribed with antibiotics; however, no improvement was observed in her complaints and lung graphics. The physical examination of the patient, routine laboratory analyses, collagen tissue markers and bronchoscopy were normal. In chest X-Ray, there were 4 nodular density approximately 1 cm in size, in the upper zone. In thorax CT, there were irregular contours multiple nodules, and the biggest one was approximately 35x7 mm in the upper lobes and in the superior of the left lower lobe of lungs. Acid fast bacteria was negative at bronchoalveolar lavage. The patient was diagnosed COP as clinically and radiologically. Then, systemic cortico steroid therapy was started. A complete clinical recovery was observed in the sixth month of the treatment and at the control thorax CT displayed that nodular lesions were disappeared completely. In the cases that were not respond to antibiotic therapy and patients having radiologically mobile and temporary infiltrations may be taken into consideration in the differential diagnosis.

Tuberculosis is a disease that can mostly be diagnosed, and may involve all organs; however also may frequently mimic other disease of the involved organs and sometimes causes diagnostic problems. In our case we presented a patient that we thought to be lung cancer, however diagnosed as tuberculosis after the evaluations. We think that in countries with high tuberculosis incidence and prevalence such as our country, tuberculosis should be kept in mind in differential diagnosis in every clinical and radiological feature.

The excessive maternal alcohol drinking results in Fetal Alcohol Syndrome which is a pathology caused by the embryotoxic effects of ethanol in prenatal period. The mechanisms of ethanol action at the cellular or molecular levels are scarce. In this study it was aimed to investigate the effects of ethanol on growth and development of mammalian embryos as well as the morphological structure and the role of free radicals on these effects. Wistar rats were obtained from the Selcuk University Experimental Medicine Research Center and their 9.5 days embryos were explanted and cultured for 48 hours in rat serum. Whole rat serum used as a culture medium fort he control group while different concentrations of ethanol (250-500 mg%) were added tor at serum fort he experimental groups. Also, the lowest effective concentration of ethanol for all parameters was added to the culture media in the presence of an antioxidant superoxide dismutase (SOD). Ten embryos were used for each experimental condition. Dose-dependent effects of ethanol on embryonic developmental parameters such as; total morphological score, yolk sac diameter, crown-rump length, somite number, embryo and yolk sac protein contents were compared using morphological and biochemical methods. Each embryo was evaluated for the presence of any malformations. Compared to the control embryos, ethanol significantly decreased all developmental parameters döşe-dependently (p<0.05) with an increase in overall dismorphology. The haematoma in different regions, especially in the neural tube was most frequently observed. When the SOD was added to theculture media in the presence of ethanol, growth and developmental parameters were improved (p<0.05) and there was a decrease in the incidence of malformations (p<0.05). A döşe dependant developmental toxicity of ethanol on rat embryos during organogenesis wasdetermined, these effects might involve free oxygen radicals.

Brucellosis is a zoonotic disease caused by bacteria of the Brucella subspecies from the gram-negative bacteria family. Brucellosis continues to be a public health problem worldwide, especially in developing countries. The bacteria can involve the reticuloendothelial system foremost, and many systems such as joints, the heart and the kidneys. Despite the respiratory system involvement being known, lung involvement is rare. Non-specific findings and complications in the patients with lung involvement makes the diagnosis difficult. In this case report, a 6-year-old male patient, presenting with the complaints of fever, cough, expectoration, hemoptysis, exhaustion, anorexia and knee ache, was hospitalized with the diagnosis of pneumonia and pleural effusion. On the performed examinations, hepatosplenomegaly and bicytopenia were detected. The Rose-Bengal test was (+++) and the Wright agglutination test was 1/1280 (+) in the blood and pleural effusion fluids of the case. The case was considered to be a pneumonia and pleural effusion due to brucella. The case has been presented since it is rarely seen, and in order to emphasize that in countries such as ours, in which brucella is endemic, complications due to brucella show a wide spectrum.

Duchenne muscular dystrophy is a progressive, hereditary neuromuscular disease with the cause of death usually occurring because of respiratory failure. The development of respiratory failure during wakefulness usually preceded by hypoventilation during sleep. The aim of this study were to assess the presence and severity of nocturnal desaturations and to determine the parameter of daytime lung function associated with nocturnal desaturations in patients with DMD. Material and method: The monitoring of overnight oxygen saturation is widely used for sleep apnoea-hypopnea screening. As our method we choosed aprospective comparison of wakeful respiratory function tests (spirometry, maximum voluntary ventilation, maximal mouth pressures, arterial blood gases) with outcomes of overnight oxymetry. Fourteen clinically stable patients with DMD, mean age (±SD) 13,83 ± 1,86 were studied. Results: The lowest oxygen saturation < 85% was present in 9 (64%) patients and oxygen desaturation index > 5 was found in 10 subjects (71%). Desaturation index was significantly related to maximum inspiratory pressure (r= -0,633, p<0,05), FVC (r= -0,730, p<0,01) and FEV1 (r= 0,664, p<0,05). However logistic regression analysis showed that overnight desaturations could not be reliably predicted from the daytime pulmonary function test results. Conclusion: Sleep-related desaturations are freguently present in clinically stable patients with DMD. Overnight desaturations can not be predicted from daytime respiratory function tests. Even in the absence of sleep-related symptomatology (headache, somnolence, etc.), sleep related respiratory disturbances should be suspected and searchhed in DMD patients.

In this study, we evaluated the first open heart operations performed in our clinic. Between August 2005 and June 2011, a total of 550 patients (318 male, 232 female; mean age 58,35 years) underwent open heart surgery in our clinic. Preoperative mean ejection fraction was 36,8% (20 to 65). Diagnosis of patients were as follows: 397 cases had coronary aryery disease, 114 cases had valvular heart disease, 19 cases had congenital heart disease, 17 cases had aortic pathology and 3 cases had left atrial myxoma. Major comorbidities were hypertension, diabetes mellitus and chronic obstructive lung disease. Mean intensive care unit stay was 2,1 days (1-17), whereas mean hospital stay was 6,7 days (4- 23). Total complication rate was 28,54% with 157 cases. The most common postoperative complication was atrial fibrilation with 57 (10,36%) cases. Low cardiac output in 23 (4,18%) patients, wound infections in 16 (2,9%) patients, temporary neurologic disorder in 13 (2,36%) patients, renal failure in 10 (1,81%) patients and mechanical ventilation requirement in 6 (1,09%) patients were observed in hospitalization period. Reoperation was used in totally 45 (8,18%) cases due to hemorrhage (n=41) and sternal dehiscence (n=4). Total mortality rate was 5,63% with 31 cases. The most common cause of mortality was low cardiac output. This study demonstrated that open heart surgery has been performed successfully in a state hospital despite the all difficulties. We think that our mortality and morbidity rates are acceptable and similar to current literature.

Congenital lobar emphysema (CLE) is a rare anomaly of lung development that presents in the neonatal period. A 13-day-old girl baby was admitted to our unit because of primary pulmonary hypoplasia. She had presented with severe dyspnea and cyanosis, where chest radiograph and chest computed tomography showed CLE and pulmonary hypoplasia. Pulmonary hypoplasia may worsen prognosis of patient. There fore, we performed a pulmonary magnetic resonance angiography in our patient. Pulmonary vasculature was normal on magnetic resonance angiography. After ward, our patient was operated. In here we would like to highlight that the use of advanced imaging techniques can identify additional pathologies which may affect prognosis after surgery.

Sigara içerenlerin bronş epitellerinde hiperplazi, siliya kaybı, selüler atipi, çok katlı yassı epitel metaplazisi, displazi, karsinoma in situ, nihayet invaziv karsinom görülür. Bütün bu premalign histolojik bulgular sigara içmeyenlerde çok nadirdir. Biz bu çalışmamızda, sigara içen ve sigara içmeyen onar hastadan alınan akciğer, akciğer lobu,akciğer segmenti ve açık akciğer biyopsilerinde bronş epitelinde meydana gelen değişiklikleri inceledik. Sigara içen hastalarda bronş bazal membranlarında kalınlaşma epitel hiperplazisi, Goblet hücrelerinde artış, bronş epitelinde siliya kaybı bulduk.

Bronchogenic cysts (BC) are rare congenital malformations arising during the development of the ventral foregut. Bronchogenic cysts form as a result of abnormal budding of the bronchial tree during embryogenesis (between 4th-6th weeks). Most bronchogenic cysts originate in the mediastinum, while 15% to 20% occur in the lung parenchyma. According to the literature, most intrapulmonary cysts occur in the lower lobes. But bronchogenic cysts are commonly found in the middle and superior mediastinum. The bronchogenic cyst in our patient was subcarinal. It was striking in terms of its giant size and laying on two hemithoraxes.The bronchogenic cysts are usually asymptomatic and often diagnosed incidentally during routine chest roentgenogram for other reasons.They may not be detected until adulthood. Our patient was 56 years old. She had no obvious symptoms . The patient was referred to our clinic because of cough,and her bronchogenic cyst was determined. Basic treatment of bronchogenic cyst consists of surgical excision. However, in cases where resection cannot be performed, the epithelium should be peeled as in our case.

The effect of cigarette smoking and age factor with obesity on PFT has been examined on 57 subjecis which 42 of them were control and 15 of them were obese. it has been established that the obesity caused obstructive and restrictive type of pulrnonary function defects, the cigarette srnoki. g rnight have been ellective on obstructive type change and there has been no significant correlation between PFT and ageing.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. For many patients, maximal therapy for COPD produces only modest or incomplete relief of disabling symptoms and these symptoms result in a significantly reduced quality of life. Despite the high morbidity and mortality associated with severe COPD, many patients receive inadequate palliative care. There are several reasons for this. First, patient– physician communication about palliative and end-of-life care is infrequent and often of poor quality. Secondly, the uncertainty in predicting prognosis for patients with COPD makes communication about end-of life care more difficult. Consequently, patients and their families frequently do not understand that severe COPD is often a progressive and terminal illness. The purpose of the present review is to give knowledge regarding palliative and end-of-life care for patients with COPD. Recent studies provide insight and guidance into ways to improve communication about end-of-life care and thereby improve the quality of palliative and end-of-life care the patients receive. Two areas that may influence the quality of care are also highlighted: 1) the role of anxiety and depression, common problems for patients with COPD; and 2) the importance of advance care planning. Improving communication represents an important opportunity for the improvement of the quality of palliative and endof-life care received by these patients.

Hypersensitivity pneumonia is an inflammatory interstitial lung disease caused by immune response due to inhalation of various organic and chemical substances. Bird fancier’s lung disease is a hypersensitivity pneumonia which develops in response to organic bird products. Hypersensitivity pneumonitis is caused by many birds, especially pigeon. In the current case, the diagnosis was subacute hypersensitivity pneumonitis. Thirty two year-old male was admitted to chest diseases outpatient clinic due to two months of effort dyspnea, dry cough, fever, sweating, fatigue and weight loss. The patient has a history of pigeon feeding. The patient was diagnosed as pigeon fancier’s lung disease by the help of the history, physical examination, pulmonary function tests, chest radiography and highresolution computed tomography findings, and he had prednisolone therapy. As a result, an early diagnosis and then early treatment after the necessary precautions are very important to avoid chronic progress of these diseases.

Those who am working in the mercury proces-sing plant and suffcring from chronic obstructive pulmonery diseasc (COPD) were studicd for possible mercury toxicity. The study reveals that about 23.95 % of the total workes were COPD patients and their problems were bccause of the cigaret smoking rather that' the toxicity from the exposure. In addition to this study we found that the workes had poor oral hygenic care.

Aim: In this study, it was aimed whether biochemical parameters, vital signs and neutrophil-lymphocyte ratio
(NLR) values could be used in determining the indication for intensive care hospitalization in COVID-19
patients.
Patients and Methods: This retrospective observational study was conducted in the emergency department
of a university hospital. Patients with positive SARS-CoV-2 PCR test who applied to our hospital on 1-31 July
2020 were included in the study. Laboratory results, demographic findings and clinical results of the patients
were collected electronically. The patients were divided into 3 groups as discharged, admitted to the service
or intensive care unit. The incidence and severity of symptoms, comorbidities, laboratory values, and NLR
values were compared between the groups.
Results: A total of 489 patients were included in the study. The mean age of the included patients was 48.69
+ 17.25 years, of which 260 (53.16%) were female. While 248 (50.9%) of these patients were discharged,
207 (42.3%) were taken to the service and 33 (6.7%) to the intensive care units. Age, heart rate, urea,
creatinine, CRP, D-dimer and NLR values of the patients admitted to the intensive care unit were higher
than the other groups, while oxygen saturation was statistically significantly lower in this group. Concomitant
systemic diseases such as Diabetes Mellitus, Essential Hypertension, Chronic Obstructive Pulmonary
Disease were more common in those hospitalized in the intensive care unit. In multivariable analysis, oxygen
saturation (OR:0.803) and neutrophil-lymphocyte ratio (OR:1.09) were found to be independent predictors of
the indication for hospitalization in the intensive care unit.
Conclusion: As a result of our study, we think that especially low oxygen saturation and high neutrophillymphocyte
ratio can be used in determining the indication for intensive care hospitalization in patients who
apply to the emergency department due to COVID-19.

Aim: Temporary hemodialysis catheters inserted into the internal juguler vein are commonly used in patients who need emergent hemodialysis. During this procedure, although it is very rare, the patient may have anatomicaldifferences. Therefore, before the procedure, it should be studied whether the patient has any cardiovascular abnormality or not. Case report: Dextrocardia was detected in control chest X-ray of a 55 year old patient, who was in routine hemodialysis programme and had a history of 10 arteriovenous fistula operations and multiple transient and permanent catheter insertions because of chronic renal failure. Conclusion: For this reason, we suggest posteroanterior chest x-ray as the routine technique since it is the simplest diagnostic method.

ABSTRACT

Aim: Avascular necrosis of the femoral head (AVN) is the necrosis of the bone and the bone marrow resulting from the injury or the occlusion of the blood supplying vessels of the femoral head. Specially it is seen in mostly young and middle aged individuals and requiring mostly surgical procedures. Despite all advances in the surgical procedures, still a high rate of the hip prosthesis is a requirement in the treatment. Hyperbaric Oxygen Therapy (HBOT) alone or in combination with surgery is reported to be effective in some clinical AVN cases. HBOT is also a treatment method which is used in ischemic diseases resulting from vascular injuries or occlusions. Enoxaparin is an antagonist of factor Xa which is found in the coagulation system. Beside its anticoagulant effect it has been shown that it has an osteopenic effect, inhibits osteoblast maturation and increases osteoclast activity in the bone.

Material and Methods: In this study effects of enoxaparin and HBOT were investigated in the treatment of experimentally formed AVN of the femoral heads of the rats. For this purpose, avascular necrosis model was applied to the left femoral heads of 64 rats and the results of the treatments alone and together were investigated.

Results: In this study results have shown that an increase in the new bone formation, and remodelisation with less changes in the cartilage tissue than in the controls. An increase in the necrotic tissue clearing rate observed in the HBOT applied groups. The best results were achieved with the HBOT and enoxaparin combined applications.

Conclusion: In this study HBOT alone, enoxaparin alone or combination of these two treatments have a positive effect in the experimental femoral head AVN and supporting the clinical studies in the femoral head AVN.

Keywords: Hyperbaric oxygen therapy, avascular necrosis, enoxaparin

Experimental studies showed that recurrent exposure to sevoflurane can be toxic. İt may be either related with direct effects of this anaesthetic agent or with the degradation of sevoflurane by soda lime which is also known to produce toxic products. The aim of this study was to investigate the effect of repeated sevoflurane anaesthesia on kidney and liver in rats vvith or vvithout soda lime. After local ethical comitte aproval thirty adult VVistar rats vvere divided into three groups. The rats were placed in a specially prepared transparant plastic box. Group C was the control group. Theyreceived 100% O2 . İn the anaesthesia circle vvithout soda-lime sevoflurane in 2.5 -2 .7 % concentration vvith O2 (100 %) were administered directly in group S, vvhile the same gas mixture was applied through the soda lime in group SS. Bepeated anesthesia (five times) was applied to the rats for sixty nainutes vvith two days intervals. Blodd ürea nitrogene, creatinin, SGOT, SGPT and ALP levels were assessed from the blood sample. Follovving sacrifice, kidneys and livers vvere obtained from the rats for examination using light microscopy for histopathological evaluation and mean damage scores (MDS) of the specimens vvere calculated. SGPT values were higherin group S and SS vvhen compared vvith group C (p<0.05). There vvere only minimal changes in histopathological evaluation of liver vvhich was not statistically significant. The changes in BUN and creatinin levels vvere not significant among the groups. The MDS’s in renal tissues vvere significantly higher in group S and SS vvhen compared vvith group C, vvhile there vvere no dif- ferences betvveen group S and SS. İt vvas concluded that repeated exposure to sevoflurane has minimal effects in liver accord- ing to mean damage score and in the presence of soda lime, sevoflurane anaesthesia vvith 100 % oxygene did not signifi­ cantly increased histopathological damage to liver. The toxic effects of sevoflurane on renal tissue vvere greater in rats espe- cially vvhen sevoflurane vvas administered through the sodalime

The protective effect of melatonin and the combination of vitamin C and vitamin E on the brain tissue of rats treated with chlorpyriphos-ethyl (CE) was investigated. The experimental groups were as follovvs: Control group (C), CE treated group (CE), vitamin E plus vitamin C treated group (Vit), melatonin treated group (Mel), vitamin E plus vitamin C plus CE treated group (Vit+CE), and melatonin plus CE treated group (Mel+CE). Vitamins and melatonin were administered to appropriate groups six days. CE was applied only fifth and sixth days. İn CE group, comparing with C group, thiobarbituric acid reactive substances was found to increase, vvhereas antioxidant potential was decreased (p<0, W) in brain tissue homogenates. Superoxide dismutase and glutathione peroxidase activities were high in CE group, comparing with C group (p<0,10). These results suggest that CE may cause oxidative stress in rat brain tissues, this oxidative stress may involve in CE toxicity, and melatonin and the combination of vitamin C and vitamin E may decrease these toxic effects caused by CE.

In this report 2365 cases that were diagnosed at the Department of Pathology of Medical School of Selçuk University between 1988-1992 are examined by age, sex, organ distribution and histopathological types. The ratio of lung carcinoma in men and skin carcinoma in women were the highest.

57 years old male patient who admitted our clinic from the intensive care unit because of the one week refracter of the treatment pleural effusion with the septic situation. The patient is a diabetic (type 2) for 13 years and lastly two years use insulin and last 10 days he has dispne, right costal pain, fever and don’t regulate blood glucose profile. The patients tension arteriale was 85/60 mmHg, heart rate was 120/min; leucocytosis 23000 and blood glucose level 470 in laboratory. PA chest film and computed thoracic tomography were reported lung abscess which the right posterior mediastineum and extrapleural look the air-fluid level. As a result of thoracentesis pleural empyema in a patient with pure liquid under the most comfortable coming right scapula chest tube (no 28) was inserted 1700 cc of purulent fluid was taking and in this case was achieved dramatic clinical improvement. Blood sugar was regulated daily pouch was washed with 300 cc riphosine fluid 10 days later, tube made under a pet. The situation is completely stable at the end of the first month.This is a rare case report of lung abscess, and being seen in the posterior mediastinum was only due to be treated with chest tube

Scimitar syndrome is a rare congenital partial pulmonary venous return anomaly that is characterized with anomalous pulmonary venous drainage of the right sided pulmonary veins to the inferior vena cava or the right atrium. It may be accompanied with hypoplasia of the right lung with bronchial abnormalities, dextra position of the heart and systemic arterial supply to the lung. Radiologically, this anomalous vein appears as a scimitar-like shadow (Turkish Swords) on chest x-ray, and runs from the middle of the right lung to the cardiophrenic angle. In our report, we have presented a child with scimitar syndrome who was evaluated for recurrent lower respiratory tract infection.

Hydatid disease is common in Turkey. The common sites of invol-vement are lungs and liver. Localisation of csyts in face and the neek are exceptionally rare. A. case of hydti.cl csyt which was localised in masseter muscle is reported.

Patients with rnalignant melanoma are usually referred to Derma-tology and Plastic Surgery Clinies. In this case a patient with malignant melanoma on the dorsal aspect of the right foot with diffused metastases complained of severe cough and to the lungs discussed. The patient hemoptysis.

The aim of the study was to investigate Octreotide (OCT), a synthetic somatostatin analogue, effects on oxidant -antioxidant status and lung histopathology in experimental sepsis. Fourty Sprague-Dawley rats were randomly divided into four groups. Group SHAM underwent only laparotomy. In Group SEPSİS, OCT-50 and OCT-100 were performed sepsis by Cecal Ligation and Perforation (CLP) technique. Group OCT-50 and group OCT-100 received subcutanously (sc) OCT 50 μg/kg and 100 μg/kg respectively after CLP. Group SHAM and group SEPSİS received in same time, route and dose SF. All rats after operation at 24 h. were sacrificed and collected blood and lung tissue samples. Erythrocyte GSH, plasma MDA and lung histopathology were assessed. In group SEPSİS , while MDA levels and lung damage scors increased in sepsis periods, GSH decreased when compared with group SHAM (p

Objective: To present a case of pulmonary hyalinizing granuloma (PHG). Case Report: The patient was a 48-year-old female who had abnormal chest X ray showing bilateral mass shadows incidentally. She was asymptomatic. Subpleural two nodules removed by open lung biopsy revealed a homogenous cut surface. Histological diagnosis was PHG consisting hyalinized collagen fibers and bundles infiltrated with chronic inflamatory cells. Conclusion: The case was presented to attract attention to take this rarely benign disease in to account in the differantial diagnose of multiple pulmonary nodules.

Between May 1984-April 1988 7 cases with destroyed lung were treated at S. Ü. Faculty of Medicine Thoracic and Cardiovascular Surgical Department. The youngest and oldest patients were 5 and 47 years old. Patients presented themselves with coughing, purulant sputum, dyspnea, pleural pain and hemoptysis. Clubbing of fingers was common in all cases. We obtained no perfusion in the destroyed lung side whom we could research. Surgical treatment with 5 pneumonectomy and 2 pleuropneumonectomy were corned out. There were 2 empyema as post operative complication with broncho-pleural fistula in one patient. This patient died following thoracoplasty. The other patient is still alive with open drainage.

Tuberculosis (TBC) is an infection that rarely seen in the first year of maximum immunosuppression. Beacuase of its rarity we aimed to present a case of TBC that developed after renal transplantation in our newly established transplantation unit. A live donor renal transplantation was performed on a 45 years old man who was complaining of chronic renal failure for four years and on hemodialysis for two years. There was no signs of TBC in the physical examination, preoperative laboratory investigation and past medical history of the patient. Prednisolone, MMF, FK-506 combination and in the 1st and 4th day Basiliximab were performed as immunosuppressive protocol. In 1 st postoperative month, there was a cavernous lesion in the left upper zone on chest x-ray. Antituberculosis treatment was started according to a positive sputum culture for TBC bacili. After twelve months of antituberculosis treatment there was a clinical and laboratory improvement and the treatment was ceased accordingly. Because of its frequent past history in our country, TBC is aserious disease that should be kept in mind and dealt with carefully in patients undergoing renal transplantation.

In this study the toxic effects of formaldehyde to lungs and protective effects of omega-3 fatty acids against these toxic effects were investigated at histological and biochemical levels. For this purpose, 21 adult male Wistar rats were divided into three groups. Rats in group I were used as control. Rats in group II were injected with formaldehyde every other day. Rats in group III Daily received omega-3 fatty acids with injection of formaldehyde. At the end of 14 days experimental period all rats were killed by decapitation. The lung tissue specimens which were taken from the rats were examined under light microscope after performing the routine histological procedures. The activities of superoxide dismutase (SOD), catalase (CAT), xanthine oxidase (XO) and malondialdehyde (MDA) were determined in the lung specimens by using spectrophotometric methods. In our study in rats whom formaldehyde was given a statistically significant increase in the levels of SOD, XO and MDA was determined when compared to control group. A significant decrease in the level of CAT was also detected. In the light microscopic examination of this group, bleeding areas in interstitium, hemosiderin loaded macrophages and ephitelial spilths on terminal bronchiales was observed. It was determined that the histological variances which caused by formaldehyde exposure were decreased in ratswhom received omega-3 fatty acids along with formeldehyde. In addition a decrease in SOD, XO, MDA levels and an increase of CAT levels were determined. Asa result, it was determined that damage accured in lung tissue of rats exposured to formaldehyde and this damage was prevented by the application of omega-3 fatty acids.

Patients with cavitary lung lesions have a high ris of morbidity and mortality with prolonged hospitalization. In this study 204 patients who were treated in Selcuk University, Chest Diseases and Thoracic Surgery departments between 1995-2003, are examined retrospectively. There were 142 (70%) men and 62 (30%) women aged from 6 to 77. Definite diagnosis was established by the presence of cavitary lung lesion in chest x ray or CT. Variable of age, sex, etiology and type of treatment, were analyzed. The most common cause of cavitary lesion was tuberculosis (36%). There were 114 (56%) right caviation, 74 (%36) left and 16 (8%) bilateral cavitation 59 (29%) cases were treated by a surgery, while 145 (%71) were treated by medical treatment and observation. Six cases were died due to respiratory failure

Radiography, ultrasonography (US) and computed tomography (CT) findings of hydatid cysts localized in the thorax were evaluated in 63 cases. Simple, complicated, or ruptured hydatid cysts were better visualized with CT than plain roentgenograms.

ABSTRACT

Aim: Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Although it can be corrected by simple methods if detected earlier, treatment failure or delay in sternal dehiscence may result in mediastinitis, which is highly lethal.  In this study, we aimed to investigate alternative sternal closure systems, mainly sternal talon (STalon) and titanium sternal plates (SPlate). Patients and Methods: In between April 2015 and January 2018, patients with sternal dehiscence after any kind of open cardiac surgery were included in this study. These patients were retrospectively evaluated according to the their demographic data, risk factors for sternal dehiscence, type of operations, techniques used for fixation of the sternum, mainly focusing on the STalon and titanium SPlate fixation. Results: A total of 45 patients were taken into surgical correction because of sternal dehiscence.  Thirty-four (75.6%) of the patients male, whereas 11 (24.4%) were female. Mean time interval after the first operation to sternal dehiscence was 68.5 days (1-780 days). Mean body-mass-index (BMI) was 31.52 kg/m² (22.03-43.69 kg/m²). Before the sternal fixation, mean CRP value was 68.34, whereas it was 75.55 before discharge. Confounding risk factors were internal mammarian artery (IMA) harvesting for coronary artery disease, diabetes mellitus, bronchial asthma, chronic pulmonary artery disease and advanced age. Mean post-operative intensive care unit (ICU) length-of-stay (LOS) was 5.02 days (1-29 days), whereas hospital LOS was 17.18 days (2-74 days). Early mortality was observed in 3 patients (6.67%). The first choice of operation was simple closure and/or Robicsek closure. Apart from simple and Robicsek closure techniques, sternal talon and/or titanium plates were used in 24 patients (53.3%). DM was found to be related to extanded total hospital LOS, ICU LOS, and postoperative time to discharge. DM also increased the risk of both superficial and deep sternal infection rates (p<0.05).  Conclusion: Ideal sternal closure should stabilize the sternum, be cost-effective and provide shortest hospital LOS with minimal post-operative complications. In patients with intact intercostal spaces, sternal talon may eliminate serious complications, such as cardiac rupture mainly caused by dense adhesions. Sternal plates are mainly effective in fragmented fractures without stable intercostal spaces. All patients should be individualized according to type of lesions and sternal fractures.

We analyzed the different parameters of the 95 cases with pulmonary carcinoma hospitalized in Chest De-partment of Süleyman Demirel University Medical Faculty rn June1995- July1998 years and we made a general evaluatiorı of the cases. Squamous cell carcinoma was present in 33.7%, adenocarcinoma in 25.3%, small carcinoma in 13.7%, large cell carcinoma in 2.1% and metastatic carcinoma in 8.4%. 16.9% of patients had na histapathologic diagnoses. Of these patients, 9.46% was in stage I, 13.51% was in stage Il, 18.92% was in stage II1A, 2702% was in stage I/IB and 31.08% was in stage IV. 81.05% of patients were smokers, when amount was considered, it was 50.70 packlyear for small cell carcinoma, 44.75 packlyear for metastatic lung cancer, 43.75 packlyear for squamous celf carcinoma and 38.00 packlyear for adenocarcinoma. When clinical findings were considered, cough (68.4%) and weight loss (63.4%) were seen most in patients. While central localization was seen 76.9% in small cell carcinoma, 62.5% in squamous cell carcirıoma; peripheric localization (71.0%) was seen mostly in adenocarcinoma. Parancimal infiltration was detected most often in squamous cell carcinorrıa (72%), soliter nodule in metastatic lung carcinoma (63%), neoplastic cavity in large cell carcinoma (50%), pleural effusion iri adenocarcinoma (46%) and mediastinal enlargement in small cell carcinoma (54%). Histopathologic diagnoses were detected by means of bronchoscopic biopsy and lavage (51.89%), sputum cytology (17.73%), pleural punc-Non and biopsy (17.73%) and transthoracal fine needle biopsy (12.65%).

We present, a case of Swyer James syndrome di-agnosed using computed tomography, characterized by unilaterale emphysema, bronchiectasis and on the same side reduced vascularity.

A 14 - year-old boy was admitted to the in-tensive care unit (ICU) of the Seljuk University Hos-pital because of a traffic accident. He had a chest tube in the middle axiller line of his right thorax on the 8 th. intercostal space. Pulmonary parenchym of the right lung had closed at his chest roentgenogram and ultrasonografi. This patient required an emer-gency operation with his symptoms and laboratory findings. Emergency thoracotomy was performed in the patient which had led to a tear in the right side of diaphragm and intrathoracic migration of the liver, hepatic filexura of the colon and the omentum were seen. Hepatic flexura of the colon had got two perforations. They have to he attentive for diagnosis and treatment after thoracoabdominal blunt trauma. Never forget that some manipulations to diagnosis or treatment may make abdominal viscera destroy in the chest.

Between, 1985 - 1986 150 bronchoscopies were perforıned in our ciinic. 60 cases were diagnosed as bronchus carcinoma. Among 90 cases; 25 cases were diagnosed as tuberculosis, 10 cases lober pneumonie, 39 patients chronic bronchitis, 15 cases lung abcess and in one case foreign material aspiration were diagnosed.

Pulmonary edema following the obstruction of an upper airway is an uncomman and unpredictable clinical situation. In this case report, it was aimed to discuss the ethiology, pathophsiology, diagnosis and treatment methods of negative pressure pulmonary edema (NPPE) that developed just after the resolution of laringopasm in the patient who underwent to gynecologic operation. Early diagnosis and treatment can affect the mortality and morbidity in NPPE.

Fourty six patients with chronic obstructive pulmonary disease(COPD), mean age 62.63±7.41, were studied to determine the effect of chronic respiratory insufficiency on penpheral sensory and motor nerve conduction. 13% of patients showed clinical symptomps or signs suggestive of neuropathy. Abnormal nerve conduction studles were found in 35% of patients suggesting a predominantly distal and sensory neuropathy of demyelinating type. Age, degree of hypoxemia, duration of disease and cigarette consumption did not significantly correlate with slowing of nerve conduction velocities. These electrophysiologic results are suggestive of a predominantly clistal and sensory neuropathy of demyelinating type that is in agreement with literature knowledge.

Tuberculosis remains to be a serious public health problem in our country and all over the world. Extrapulmonary tuberculosis causes major clinical problems because of difficulties encountered in the differential diagnosis. In this case report, we aimed to discuss a case of tuberculous lymphadenitis mimicking mediastinal tumor in chest CT and PET-CT examination. Eighty years old female patient with right paratracheal enlargement in the chest radiography was admitted to our hospital. Thorax CT and MR imaging was supporting this expansion as concordant with the mediastinal tumor. The PETCT showed increased FDG uptake in favor of malignant masses. However, mediastinoscopic biopsy was reported as tuberculous lymphadenitis and antituberculous therapy was started. It should be kept in mind that even in adults patients, tuberculous lymphadenitis should be thought in differential diagnosis of mediastinal masses suspecting malignancy with imaging techniques and also it should not be forgotten that tuberculous lymphadenitis may be presented with elevated FDG uptake at PET-BT.

Chest pain is the most common reason of emergency service visits and is analysed in two subdivisions as cardiac and non-cardiac. Pain of cardiac origin is well understood but pathophysiology of non-cardiac chest pain is complex and poorly understood. In this study, we aimed to assess the characteristics of patients and final diagnoses of patienets admitted to pulmonary clinic with chest pain. In our study, we prospectively analyzed 97 male and 103 female in a total 200 patients who admitted to pulmonary clinic with chest pain. Demographic, clinic characteristics, medical and family histories were noted. After their consultation with the relevant clinic within indications their final diagnosis were recorded. According to the results, pain with musculoskeletal origin was the most common, gastrooesophageal reflux the second, chronic obstructive pulmonary disease, asthma and acute bronchitis related chest pain was the third most common reason. In conclusion majority of patients admitted to pulmonary clinics with chest pain mostly are related to musculoskeletal reasons. On the other hand, patients with chronic obstructive pulmonary disease, asthma and acute bronchitis patients especially who are not diagnosed yet may define shortnes of breath and chest tightness as chest pain.

Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. In this report, we present a rare case of Langerhans cell histiocytosis with CT and MRI in a 2 yearold-boy who developed symptomatic diabetes insipidus and multiple bone ,cranial, lung and spleen metastases during the disease course. A 2-year-old male patient was hospitalized due to complaints of cough, fever, vomitting, diarrhea, achromasia, weakness and rash. Chest X-ray revealed reticulonodular infiltration in both lung fields. Thorax CT revealed diffuse micro and macro nodular type infiltration in both lung parenchyma. On CT and MRI revealed common lytic lesion of skull, vertebra and iliac bone. There are infundibular thickening and absence of posterior pituitary intensity on MRI of pituitary gland. The spleen involvoment is determined by abdominal CT. The diagnosis is confirmed with biopsy of iliac bone. Langerhans cell histiocytosis should be in the differential diagnosis in children having widespread lung, bone, pituitary gland, and spleen involvement on MRI and CT.

An 11 - year old boy presented to the emergency room with severe dyspnea and left upper chest pain. The initial chest radiograph showed a massive left pleural effusion, opacities in the left hemithorax and lytic areas in the left 3rd rib. A thoracocentesis demonstrated a hemothorax. Despite treatment with blood tansfusions and aspiration of hemothorax, the patient’s clinical status worsened and developed dyspnea. A thoracic computed tomograghic scan demonstrated a mass in the intrathoracic extrapulmonary space and a lytic lesion in the 3rd rib. A posterolateral thoracotomy was performed. Base on histologic findings, evving’s sarcoma vvas diagnosed. He was asymptomatic throughout the 11 months follovv - up. İntrathoracic extrapulmonary thoracic Evving’s sarcoma with spontaneous hemothroax is extremelyare.

Breast cancer is the most frequently diagnosed cancer in women and second cancer leading death among cancer deaths in women (after lung cancer). Simultaneous bilateral breast cancer is seen 1-2% and metachronous 5-8%. Bilateral breast cancer has worse prognosis than unilateral breast cancer. Locoregional recurrences after mastectomy is often occure in bone, muscle, skin or subcutaneous tissue of the chest wall, and that was seen approximately until 2 years. In skin metastases; asymmetric nodules, eritematose rash, itching, bleeding, ulceration, symptoms and signs such as necrotic exuda can be seen. Breast cancer treatment should be made by a multidisciplinary team. Radiotherapy in these patients are curative or palliative. In this case, we aimed to show the effectiveness of the electron beam in modern radiotherapy.

Croup syndrome is a term that defines barking cough , hoarseness, inspiratory stridor, and presenting with changeable severity of respiratory distress according to the l (severity) of obstruction, Foreign body aspirations, retropharyngeal abscess, bacterial tracheits and epiglottitis are also reasons for croup like acute airway obstructions. We a 4 years old child with biphasic stridorwho admitted to the Pediatric Emergencydepartment In consequence of unresponsive medical treatment pati endoscophic examination has performed and a Szygium aromaticum at the level of vocal cordswas found The foreign body had removed with general anesthesia by endoscophy.

A pulmonary sequestration is a segment or lobe of lung tissue that has no bronchial communication with the normal tracheobronchial tree. The arterial blood supply is from a systemic vessel. Both ext-ralober and intralober varietes have been re-cognised and while believed to have a common emb-ryologic origin.

Foreign body aspirations (FBA), which have high mortality and morbidity rate, are common pediatric emergency issues occured in childhood. FBA is seen more frequently among children under 3 years old. If there is no history of sudden-onset choking and cough, it can be ignored and the patient may come with recurrent pulmonary infections and its related complications. In this report, 10-monthold boy patient who was brought with complaints of sudden-onset of cough, vomiting and wheezing after eating a kind of broad bean ( termiye) was presented. Diagnosis was established on the history, physical examination, the chest X-ray and bronchoscopy. The foreign body (termiye) was located in the right inferior bronchus and removed. This case emphasizes that the presence of a foreign body aspiration must be kept in mind in childhood. Because foreign body aspiration is a serious problem that may lead to complications or even to death.

Swyer-James Syndrome is a rare pulmonary disease, characterized by one-sided hyperlucency, smaller hilum shadow and lack of vascular structures in affected side. Although usually asymptomatic, can also be symptoms such as recurrent lung infection, exertional dyspnea and hemoptysis. 23-year-old male patient presented with exercise-induced dyspnea. On physical examination, decreased breath sounds on the left hemithoraxes. Chest x-ray showed right middle and lower lobe more prominent hyperlucency, mediastinal shift to the left and small hilar shadow. Ventilation-perfusion scintigraphy were determined consistent defect areas. Swyer-James Syndrome diagnosed by chest X-ray is possible, but it is unthinkable because of the rarity. Swyer-James syndrome diagnosed patient is presented with literature data.

We evaluated 391 (267 male, 124 female) tuberculosis patients received chemotherapy in the Department of Pul- monary Diseases betvveen 1992 and 1995. For this purpose, we investigated hospital and dispanseries fileş of these patients. İn 323 (80.0 %) cases, definite bacteriologic or pathologic diagnosis of tuberculosis vvere made. Asidoresistant bacilli vvere positive in 246 (81.7 %) of pulmonary tuberculosis cases who had the microbiological evaluation of sputum and 128 (42.5 %) cases had positive culture. Drug susceptibility tests vvere made in 122 cases, 82 (67.2 %) of these cases had at least resistance to on e of the drugs. Primer and seconder durg- resistance vvere 38.5 % and 28.7 %, respectively. The follow up of 92 (23.5 %) cases was not regular and their management was not continued. The registrations of 68 (17.3 %) of these cases vvere not found in the dis­ panseries. Ali these findings shovv that efforts of tuberculosis control and education are insufficient in our city.

Chlorine is a strong oxidizing agent. There are several forms of exposure: industrial leaks, environmental re-leases occurring prirnarily in transport or water purification swimming pool-related events and houselhold-cleaning product misadventures. The toxic effect of inhaled chlorine gas on the respiratory tract has been known but there is insufficient evidence ta conclude that there is a chronic impairment of pulmonary function after acute or chronic exposure. Chlorine inhalation may manifest any of the full spectrum of pulmonary irritant effects, from minor mucosal response ta diffuse alveoler damage, may rapidly cause pulmonary edema and interstitial pne-umania, leading to acute hypoxemic respiratory failure. Pulmonary function tesis obtained following inhalation were most notable for airflow obstruction and air trapping. Follow up studies of World War 1 chlorine gas victims indicate that many of the survivors were subsequently disabled by asthma, chronic bronchitis and emphysema. fn aur cases, following chlorine gas inhalation widespread bronchial inflammation and hyperreactivity, and airway obstruction occurred. Airway obstruction resporıded to medicai treatment.

in this study, the risks of emergency surgical procedures in elderly patients and the effect of surgery on the morbidity and mortality were investigated. The records of 884 patients, those who were 65 years old or elder, and who were operated on in the Department of Surgery, University of Selçuk beetwen May 1991 and April 1997 were analyzed, retrospectively. One hundred eighty three patients (20.7%) were operated on urgently and 701 patients (79.3%) were elective. The ratio of male ifemale was 1.9 (120M/63F) and the mean age was 72.3 (range 65-95) in the emergency operations. Most frequent reason for the emergency operations were intestinal obstruction (49 cases), acute mesenteric ischemia (24 cases) and pepic ulcer perforation (23 cases). Mean hospital stay was 10.8 days (3-51 days) in the emergency and 7.2 days (1-41 days) in the elective operation (p<0.0001). The mor-tality was 18.6% in the emergency and 3.4% in the elective operations (p<0.0001). There was no correlation bet-ween mortality rates in different age groups (p>0.05). The highest mortality was observed in intraabdominal abs-cess and in perforated gallbladder disease. Intestinal resection and anastomosis was performed in 55.9% of expired cases. The majority of the patients (70.6%), who had died, had coexisting cardiopulmonary diseases. The main causes of death in alt patients were sepsis and cordio-pulmonary diseases. The main causes of death in all patients were sepsis and cardio-pulmonary failure. In conclusion, age is not a contraindication for an emergency operation and does not affect mortality which appears to be directly related to the severity and nature of the di-sease and to the coexisting cordio-pulmonary diseases. For this reason, timing is very important in the operations of elderly patients, and it is wise to perform the most conservative operation in some severe surgical conditions.

Cystic fibrosis (CF) which is occurred by mutations in the gene regulation of transmembrane message shows autosomal recessive inheritance. It is also the most common fatal diseases in white race. The frequency of disease is estimated as 1/2500-1/3500 in white race, 1/1700 in African Americans. But the frequency of CF is not known for our countries. In this study, the frequency of disease was tried to find in children with malnutrition and/or recurrent pulmonary infections who admitted to hospital. This prospective study was conducted between February 2007 and January 2010 and children with malnutrition and/or recurrent pulmonary infections were enrolled the study. The diagnosis CF was made by using positive sweat test and appropriate clinical findings and rule out of other diseases which also caused recurrent pulmonary infections or malnutrition. A total of 491 children were enrolled the study. The mean age of children was 26,1±35.01 months with the range of 2-216 months. Of all children, 335 (68.3%) were male and 156 (31.7%) were female. Positive sweat test was found in 35 (7.1 %) children. The frequency of CF was found to be 5.3 % in children with malnutrition and 8.8 % in children with recurrent pulmonary infections. Finally we emphasized one more times that CF should be keep in mind in children with malnutrition and/or recurrent pulmonary infections due to its early diagnosis and prevention of late complications.

Bullous lung disease, one of the serious pulmonary diseases which is mostly observed together with paraseptal emphysema spreads on the outer part of lobulus adjacent to septums between pulmonary lobulus. It is widely common among smokers’ upper lobs. This patients present with spontaneous pneumothorax. And foreign bodies in bronchial system is a situation mostly emerging at childhod which has critical importance in terms of its consequences and complications. If not pulled out, foreign bodies remaining inside bronchi for extended periods can cause complications such as bronchial stenosis, abscess and bronchiectasis. In our case, the patient was a chronic smoker who applied us having spontaneous pneumothorax. Bilateral giant bullae spreaded on lower lobes was spotted. Organized foreign body in the neighbourhood of throughly grown up bullae formation segment on distal part of right lower lobe was observed during the surgery. Agents of bronchial obstruction can cause proteolytic – antiproteolitik imbalance in check-valve mechanism and inflammatory process. This circumstance can harm the lungs or increase the existing harm. Localization of bullae in the lower lobes rather than their standard location and presence of a foreign body is a rare occasion of association for bullous diseases.

Purpose: To determine the effect of NAC therapy on plasma levels the protective role of tissue injury and organ dysfunction of free oxygen radicals in experimental sepsis model. Material and method: 30 female rabbits were divided into 3 groups, each composed of 10 rabbits. Sepsis was constituted by caeucum ligation perforation tecnique. Groups named sham, sepsis and sepsis + NAC (10mg/kg/day) were formed and medication was given 12 and 24 hours after caeucum ligation and perforation. At the same time blood samples to measure blood gases, plasma glutathion (GSH), malondialdehyde (MDA) and biochemical diagnosis were collected. Tissue samples were obtained. Findings: Plasma GSH levels were elevated in NAC group with respect to sepsis group (P<0.05). Plasma MDA levels were decreased in sepsis group when compared to NAC group (P<0.05). Liver tissue MDA levels were found to be same in both groups. AST, ALT and creatinine values were elevated significantly in NAC group when compared to sepsis group (P<0.05). Apoptosis in liver tissue was significantly decreased in NAC group when compared to sepsis group (P<0.05). Degree of mononuclear infiltration in kidneys were decreased in NAC group when compared to sepsis group (P<0.05). Conclusion: Application of low dose NAC an antioxidative agent in experimental sepsis model has beneficial effects on pulmonary functions and plasma MDA, GSH levels. More and comprehensive studies which tests different NAC doses are needed to determine the role for NAC in experimental sepsis model.

It was reported that there is relationship between high brain natriuretic peptide (BNP) levels and mortality in chronic obstructive pulmonary disease (COPD). In this study, we investigated effect of NIV to the BNP and troponin. Fifty eight cases with COPD were enrolled to this study. The patients were divided into two groups as cases receiving NIV (n:41) and cases not receiving NIV (n:17). In both groups pretreatment and posttreatment pro BNP and troponin levels were measured. Initially, in NIV group both pro-BNP (2013.95 pg/ml) and troponin (0.17 ng/ml) levels were significantly higher than those of control group (328.9 pg/ml and 0.02 ng/ml, respectively) (p0.05). In conclusion, in severe COPD acute exacerbations that develop respiratory failure, both pro-BNP and troponin levels increase significantly. This increase suggests that in COPD exacerbations, depending on severity of exacerbation right ventricle load and pulmonary hypertension may be more prominent and myocardial injury may accompany this. In COPD exacerbations, NIV treatment could safely decrease the increased pro-BNP levels without increasing the myocardial injury.

Iron is a medication that is used more in iron deficiency anemia. The use of iron in high doses can cause a multisystemic effect. The toxicity of iron depends upon the amount of elemental iron ingested. The minimum toxic dose and the lethal doses of iron are not firmly established. However, side effects that may be life-threatening are seen on the heart and liver. This paper presents a 16-year-old patient who used 720 mg; 12mg / kg / dose preparation of iron for suicide purposes. The control blood tests performed while planning the discharge of the patient, who had no complaints but were followed up clinically, continued to be followed up because of the increase in the value of troponin. The patient who has no record of physical examination, electrocardiogram (ECG), echocardiography (ECO) and indication for iron chelation and in whose troponin level a decrease was diagnosed in the monitoring was discharged with recommendations. Due to the rare occurrence of cardiac involvement and being the first case reported in our country, the effects of the drug on toxicity were discussed in the light of the literature.

 

Aim: Chest radiography and thoracic computed tomography (CT) play an important role in the diagnosis and
prognosis of sarcoidosis, a systemic granulomatous disease characterized by non-caseating granulomas.
Pulmonary hypertension, a rare complication of the disease, can be seen in all stages. There is a strong
correlation between pulmonary hypertension (PH) and an increase in the diameter of the main pulmonary
artery (MPAD). In this study, we aimed to evaluate MPAD with multislice computed tomography (CT)
examination for the early diagnosis of PH in patients with stag e II sarcoidosis.
Patients and Methods: We measured the diameter of the main pulmonary artery on thorax CT in patients
with stage II sarcoidosis, who were followed up in our hospital with a diagnosis of sarcoidosis between
January-2018 and December-2021, with hilar lymphadenopathy and parenchymal changes in their imaging,
and compared them with the control group, whose chest X-ray was normal and thorax CT scan was performed
with nonspecific symptoms. We evaluated the relationship between the pulmonary artery pressures obtained
by echocardiography and the diameter of the main pulmonary arte ry in patients with stage II sarcoidosis
Results: We found a significant correlation between the increase in MPAD and pulmonary artery pressure
measured by ECHO in patients with sarcoidosis compared to the control group, and the pulmonary artery
diameter measured by CT in this patient group.
Conclusion: We think that CT evaluation of pulmonary artery diameter in patients with sarcoidosis can guide
the development of PH and therefore of fer an opportunity for early intervention.

Hepatoblastorna appears largely in infants and are seldorn after 2 years of age. it rnetastasizes to lungs, brain and lymph nodes. Histologically, there are two types of hepatoblastorna: Epithelial type and rnixed type. Differentiation of this turnor from hepatocarcinornais difficult. In this report we presented a case of hepatoblastorna and di.vcussed its elinicopathologic features according to literature data.

Bronchial carcinoid tumors constitute approximately 5 percent of all lung tumors. They occur with about equal frequency in both sexes. Most patients are young or middle aged adults. These tumors are not related to cigarette smoking or other known pulmonary carcinogenic factors. Dependent upon the location of the tumor within the lung clinical presentation and morphologic appearance, these tumors are four variants. These variants are the central carcinoid, the peripheral carcinoid, atypical carcinoid, tumorlet type bronchial carcinoid. In this study, two cases diagnosed as bronchial carcinoid turner in Pathology Depart-ment of Medical School of Selçuk University between May 1987 -April 1988 were presented and discusseJ.

Bronchial carcinoid tumors constitute approximately 5 percent of all lung tumors. They occur with about equal frequency in both sexes. Most patients are young or middle aged adults. These tumors are not related to cigarette smoking or other known pulmonary carcinogenic factors. Dependent upon the location of the tumor within the lung clinical presentation and morphologic appearance, these tumors are four variants. These variants are the central carcinoid, the peripheral carcinoid, atypical carcinoid, tumorlet type bronchial carcinoid. In this study, two cases diagnosed as bronchial carcinoid turner in Pathology Depart-ment of Medical School of Selçuk University between May 1987 -April 1988 were presented and discusseJ.

Medical interventions to the patients from whom healing expectations (with the current technological and scientific data) were considered to be lost are being ethically discussed about the benefit and loss to the patient. When it is about the limited sources of the country, particularly like the intensive care units, it becomes an administrative issue. In this study we evaluated the patients in the terminal phase of their diseases with no expectancy of healing, hospitalized in the medical intensive care unit (ICU)of our university hospital. Thirteen terminal phase patients out of 73 patients hospitalized between 25 October 2010 and 30 April 2011 were evaluated retrospectively in ICU. Eleven of the patients had oncological disease (6 lung cancers and 5 other organ cancers). These patients had widespread metastases not responding to therapy. Tree of the other patients had ejection fraction lower than 15% following myocardial infarction with no chance for transplantation due to low health status, one had advanced respiratory muscle involvement due to muscular dystrophy, the another had intersitisyel lung diseases with severe respiratory failure, the other had liver cirrhosis with multiple complications. Fifteen patients died in the intensive care unit, whereas two patient was discharged with home mechanical ventilator support. Medical cost of the patients was 208.200,640/TL. They were hospitalized for 233 bed/days. The number of beds occupied by these terminal phase patients in this period were considered to be high. Foundation of palliative care units or hospice service with necessary law evaluations, is very useful and important not only for optimal use of limited financial sources but also for comfort of patient and relatives.

Aim: In the present study, the aim is to determine whether centromere protein H (CENPH) gene expression levels change in prostate carcinoma (PCa).
Materials and Methods: Prostate tissue sample of 40 patients with primary prostate cancer was used in the study. Hence, transcriptional analysis of the CENPH gene was conducted in the total paraffin embedded prostate tissues extracted from patients diagnosed with prostate cancer. The expression analyses were obtained from the comparison of the expressions within the tumoral and non-tumoral areas in the prostate tissue of the same patient.
Results: Separate RNA isolation was performed. Subsequent qRT-PCR analyzes were repeated three times and quality controls of the Ct values were performed on the obtained data. The Ct values of the expression of the housekeeping gene GAPDH and the target gene CENPH gene were compared in tissue (tumor and normal) and technical repeat groups. There was no statistically significant difference in CENPH gene expression between tumor and normal tissue specimens in prostate cancer. Moreover, on investigating the causes of death, in none of the patients PCa related death was determined. 
Conclusion: In our study, we could not find any relationship with prostate cancer tumorogenesis in CENPH gene expression anomalies. However, some cancers (non-small cell lung cancer, colon cancer, etc) with high CENPH gene expression are associated with tumor aggressiveness, poor prognosis and drugresistance. More studies are needed on CENPH gene expression and its effect on prostate cancer.

Mediastinoscopy is a widely used technique in the diagnosis of staging of lung cancer and primary and secondary mediastinal disease. İt was reported that mediastinoscopy was greater than sensitivity of %75 and specificity of % 90. We retrospectively revievved 24 mediastinoscopy performed in our clinic betvveen January 1999 and December 2002. There were 17 men and 7 women aged from 24 to 77 (mean age 57 years ) and the duration of operation was 30- 60 minutes. Eight patients had mediastinoscopy for the staging of lung cancer and sixteen patients for diagnosis of mediastinal mass. İn 3 of 8 patients N2 and N3 disease was identified. İt was suggested that these patients were inoperable. İn six- teen patients with mediastinal disease, sarcoidosis was diagnosed in 5 patients, non small celi lung cancer in 4 patients, tuberculosis in 4 patients, lymphoma in one patient, lung fibrosis and reactive lymph nodes in two patients. There were no complications and mortality in our cases. We conclude that mediastinoscopy is highly effective and safe procedure in the diagnosis of mediastinal diseases and staging of the lung cancers.

Chest pain is a common complaint in children. It doesn’t usually indicate a cardiac problem but it is considered as heartache by the patients and their families. In this article, the patients with chest pain in pediatric cardiology clinic for the last 18 months have been evaluated and the etiology of chest pain has been discussed. The study includes 441 patients with chest pain, who were admitted to the Department of pediatrics, Division of pediatric cardiology, Faculty of Medicine, Selçuk University between May 2011 and November 2012. The data of the patients has been reviewed retrospectively. Medical history and family history of the patients, cardiac physical examination, electrocardiography, echocardiography, 24-hour rhythm holter monitoring, exercise testing and laboratory tests have been evaluated. In our study the mean age of the patients was 11 (5-18 year-old). 217 (49.2%) of the patients were male and 224 (50.8%) of the patients were female. Medical history, physical examination, electrocardiography and echocardiography of all the patients have been evaluated. Cardiac pathology has been recognized in 10 (2.3%) of the patients. The reasons that cause chest pain are idiopathic in 378 (85.7%) patients, psychological in 22 (5%) patients, lung diseases in 20 (4.5%) patients, gastrointestinal disorders in 6 (1.4%) patients, musculoskeletal system diseases in 3 (0.7%) patients, Familial Mediterranean Fever in 1 (0.2%) patient and pectus excavatum in 1 (0.2%) patient. According to this study, the etiology of chest pain in children is extra cardiac factors in majority. Differential diagnosis should be made carefully due to possibility of life threatening consequences of cardiac disorders. If there is no cardiac pathology as a result of medical history, physical examination and laboratory tests the patient and the family should be informed about this.

Objective: Evaluation of pulmonary function of female patients with rheumatoid arthritis (RA) with or without pathological findings and comparision made according to high resolution computed tomography (HRCT) were also included to the study. Methods: Total 51 volunteers thirty-two female RA patients and 19 control subjects ali ranged from 16 to 66 years of age were studied. AH patients and subjects first performed pulmonary function test (PFT). Chest x-ray films, HRCT of lung were obtained for both patients and Controls. Results: Patients with RA were divided into two groups: the ones who had pathologic findings on their lung according to HRCT, and the ones who had not. PFT values of both groups were compaired with Controls. FVC, FEV-f, FEF25-75% a n d F E F 75-85% values were significantly different in patients with pathologic findings as compared with the ones who had no pathologic findings (p<0.05). There were no significant difference between the patients with no pathologic findings and the Controls. Conclusion: Following the HRCT inspection of RA patients some changes of PFT were observed in RA patients with some pathological findings on their lungs. İt has been concluded that PFT should give as useful criteria as HRCT.

Lesions in the peripheral lung area chest roentgenograms may be examined by ultrasonography. Solid and cystic lesions may be differentiated with ultrasonography (Us). ln 49 of 57 patients the US diagnosi.s of cases was correct. In 25(%51) of 49 patients lung !umar was diagnosed. In 6(%12) cases pneumonia, in 6(%12) cases hydatid cyst, in '" 5(%6) cases empyerna. in 3 (%6) cases encapsuie fluid collection, in 2(%4) cases absces5', in 1(%2) cases left ventrikül anevriysm and in 1(%2) case pericardial hydatid cyst were diagnosed. Consolidations were imagined in solid structures that include hypoechoic and branching sutructures. Tumors were imagined ta be more echogenic and homogeneus solid maseses. Atelectasis waüs imagined in structures consist of hypoechois bronchial and vascular echoes.

Traumatic diaphragmatic rupture (TDR) is recognized consequence of high velocity blunt trauma to the abdomen. TDR is uncommon injury but an important marker of severe trauma. The recognition of diaphragmatic rupture is important because of the frequency and severity of associated injuries.The treatment of TDR is surgical repair. In this case report, two patients with TDR were described.

Colon and rectum cancer, is called for colorectal cancer. Colorectal cancer, is a major health problem especially of developed western countries. The prevalence in U.S., Canada, Britain France, Germany varies between 40-60 per thousand faces. In the United States per year is approximately 150.000, in Europe, 170,000 ,a million new cases are seen all in the world. The prevalence of new cases of cancer in the U.S. in the third place receives 11%, while in European countries after lung cancer is the most common cause of cancer death (1).

The aim of this study was to evaluate the cytologic and histopathologic results of sputum, bronchial lavage fluid, and biopsy materials and to compare their diagnostic Utilities especially in the patiets with malignity. Sputum and bronchial lavage cytologies and bronchial biopsies send to the pathology department of medical faculty between January 1996 and December 2000 were reevaluated by archive scanning. Malign lung cytologies and biopsies were compared with each other, as well as diagnostic distribution of cytology. Of the 1140 sputum cytology mate­ rial, 8.7% had malignant diagnosis. For the patient having single sputum specimen, the rate of malign diagnosis was 2.2%, and for those multipl sputum specimens 18.1%>. Of the 283 bronchial lavage material, 8.6% had malig­ nant diagnosis. The rates of malignant diagnosis were 6.8% and 24.2% for the patient having single lavage spec­ imen and multipl specimens respectively. The number of the patient with negative malignity for biopsy and posi­ tive malignity for sputum was 31 and similaly lavage positive and biopsy negative was 10. Cytologic diagnoses were negative in 41 of the 63 patients who having both each material (sputum, lavage biopsy) and diagnosed with biopsies. İn this patients when sputum and bronchial lavage are evaluated with together the rate of positive diag­ nosis was 34.9°/o, for sputum it self 30.2%> and for bronchial lavage 17.5%>. İn the 185 patient considered to have malignity positive results were obtained in the rates of 62.7%, 29.8%, 11.49% and 84.9% for biopsy, sputum, lavage and ali, respectively. As conclusion, repeated sputum cytologies increases the rate of positive diagnosis as much as 8 times, and bronchial lavage 3.5 times. Positive diagnoses will significantly increases if three diagnos­ tic methods are evaluated with together (p<0.001). İn the case of biopsy failure, the diagnostic importance sputum and bronchial lavage is further increasing.

The study was carried out on thı-ee groups of rats as fallows: Control group, alcohol fed group and pair - fed group. The alcohol group was fed for 12 days with a diet containing 4,5g1kgiday ethyl alcohol. The pair fed group was giren glııco..ve (7.88 glkglgün) whi•h calory level was equal to the ealory level of alcohol giren to the second group. At the end of the jeeding period, fas-ting serum glucose, triglycerid, phospholipid and jree fatty acid leveis were measured in the serum of those three groups. The postınortal histological changes ira liver, kidneys„rtomach, spleen and lung were examined bir light microscopy. Triglycerid, phospholipid and fi-ee faty acid levels of alcohol group were higheı- than those of conwol and pair -feci group. Verv common high mitotic activity (in the' early pro-phase) in the hepatocytes at the peripheral of the elassical lobules, semidiffilse hemorrhagies in the glomerıdes and eıythrocytes infiltrated into the intertubuler area were seen at the light microscopic e_x-amination of the liver and kidney specimen.s of al-cohol giyen group. it concluded that the level of triglycerid, phospholipid and free fatty acid increase in serum due tü alcohol intake. it is supposed that th.e increase is not related with alcohol calory but it may be related with general effect of alcohol on nıe-tabolic activity of human Body.

Prostanoidler, güçlü biyolojik etkinlik gösteren endojen maddeler olup siklooksijenaz ürünü olan prostaglandinler, prostasiklin, tromboksanlar ve lipooksijenaz ürünü olan lökotrienlcr olarak dört alt grupta toplanabilir (1). Prostoglandinlerin siklopentan hal-kasındaki substituentlerin pozisyonuna göre A, B, C, D, E ve F gibi birçok çeşitleri vardır. Biyolojik yönden en önemli türevler PGE ve PGF grubudur (2). Hemen hemen tüm dokularda sentez edilirler. Sentezlendikleri dokuda bulunan enzimlerle veya kan dolaşımı ile akciğer, karaciğer ve böbrek korteksinden geçerken bu organlardaki enzimler tarafmdan inaktive edilirler (3). Bu hızlı inaktivasyon nedeniyle prostanoidler lokal hormo-n olarak kabul edilirler. PGEI, PGE2 ve PGFlerin inaktivasyonundan sorumlu organ akciğerleri PGI2 (prostasiklin) ve 6-keto PGE1 inaktivasyonundan sorumlu organ ise karaciğerdir (4, 5, 6 )

Organ tuberculosis is an important problem for the public health in devoloping countries. Tuberculosis can be seen on any part of the gastrointestinal tract from mouth to anus. Esophageal tuberculosis is very rarely seen with 0.14% prevalance. It usually originates from mediastinal tuberculous lymphadenopathy. We report a 55-year-old woman who admitted to our hospital with complaints of dysphagia, weight loss, audinophagia and epigastric pain. The chest radiography revealed a linear opacity compatible with fibrotic tape was seen on chest x-ray. Thorax CT examination revealed milimetric calcified lymph nodes at subcarinal and the right hilar region, thickening of proximal part of esophageal wall through carinal leveland subsegmenter collapse on left lower lobe. Ulcerative lesion with dimension of 1×1 cm localized in the 19th cm of the esophagus was seen on upper gastrointestinal endoscopy, suggesting esophageal carcinoma. Biopsy revealed necrotizing granulomatous ulceration which resembled tuberculosis. After antituberculous chemotherapy, the endoscopy repeated in end of the 2nd month of antituberculous therapy and the recovery of ulcer lesion was seen and the biopsy showed no signs of tuberculosis. Conclusion; esophageal tuberculosis should be kept in mind at differential diagnosis in patients who have complaints of dysphagia and loss weight and radiological signs.

Spinal epidural air associated with spontaneous pneumothorax is a rare condition. There was a pneumothorax in the patient had no history. Pneumothorax was demostrated chest X-ray and thorax CT. Moreover, CT showed also spinal air. This finding was discussed with literatüre

Spinal epidural air associated with spontaneous pneumothorax is a rare condition. There was a pneumothorax in the patient had no history. Pneumothorax was demostrated chest X-ray and thorax CT. Moreover, CT showed also spinal air. This finding was discussed with literatüre

Localized solitary fibrous tumor of the pleura is a rarely seen tumor of the pleura beyond It’s unclear histogenesis, differantiation, malignity potential, and clinical behaviour. They are usually seen in 5-8. decades and more than 50 % of the cases are asymptomatic. The most important prognostic factors are the size, cellularity, and resectability of the tumor. For these reasons in surgical treatment wide resection is advised. İn this article, two female patients who were 48 and 53 year-old are reported with the diagnosis of localized solitary fibrous tumor originated from diaphragmatic pleura. The tumors removed successfully and the patients did not have any complication postoperatively. Because of the rareness of localized solitary fibrous tumor of the pleura it is thought to be worth reporting.

In our experience, recurrence of lung hydatid cyst is not common, although liver hydatic cysts have high recurrence rale. In order to evolve experimental hydatic cysts in lung, we inoculated the hydatic fluid.s. of liver and lung hydatic cysts ta the lungs and peritoneal cavities of rabbits. The aniınals were sacrıfied at 14'h week and in exploration, there were hydatic cysts in lungs and pleura in boih groups and it was signıficant statistically (p<0.01). conclit.yion, we recomınend that care mut be taken ta prevent the patients with hydatid disease from secondary hydatidosis.

Post-traumatic pseudocysts of lung are rarely seen complications of blunt chest traumas. Usually spontaneous resolution is seen in 2- 4 months after trauma, but a few of them are get into abscess or tension cyst formation after Progressive expansion and in these circumstances surgical resection is indicated. Radiologically they are frequently seen as thin-wall cysts consisting air-liquid levels. Unless they had a drainage bronchus in the beginning they are usually seen as pulmonary hematomas due to hemorrhage. 14/e herein report 15, 17, 47 and 49 year old four cases who were hospitalized for blunt chest traumas in our clinic. Three of them were male and one was female. Ali the pseudocysts localized in the right lung, and in two of the case the cysts resolved in a period of 2.5 and 4 months with medical treatment. But in two cases surgical treatment needed for their Progressive expansions.

Aim: In this study, we aimed to discuss our experience and results of non-operating room anesthesia.

Materials and Methods: Anesthesia records of patients older than 18 years who underwent sedo-analgesia outside the operating room for diagnosis and treatment between May 2017 and December 2017 were retrospectively screened. The records were examined in terms of demographic data, applied procedure, duration of the procedure, sedation grade, medications used, developing minor and major complications, chronic obstructive pulmonary disease story and intensive care need. Relationships between complications with demographic data and categorical variables were analyzed.

Results: Totally 2562 patients underwent sedo-analgesia. 1428 (55.7%) of these cases were female and 1134 (44.3%) of them were male. The average age of patients was 53.08±16.55. 268 (10.5%) of the cases were ASA I, 1683 (65.7%) were ASA II, 598 (23.3%) were ASA III and 13 (0.5%) were ASA IV. 519 (20.3%) patients were minimally sedated, 1541 (60.1%) were moderate sedated and 502 (19.6%) deep sedated. The longest procedure time in endoscopic retrograde cholangiopancreatography was 28.7 ± 16.3 min, and the shortest procedure time in endoscopy was 10.3 ± 3.1 min. The most commonly performed procedure was colonoscopy with 31%. The most commonly used drug combination was midazolam + propofol + fentanyl applied to 1231 patients (48%). 148 (5.76%) patients had minor complication, and 10 (0.37%) patients had major complication. A total of 15 (0.58%) patients underwent intensive care after the procedure. Desaturation was statistically significantly higher in patients with ASA III and above, in procedures take longer than 15 minutes, in patients older than 65 years, and in the presence of chronic obstructive pulmonary disease. The intensive care need after the procedure was also significantly higher in these patient groups.

Conclusion: The incidence of non-operating room anesthesia is increasing steadily. The risks associated with these practices are similar to the anesthesia in the operating room. In order to increase patient safety and reduce complications, it is important to carry out a thorough evaluation before the procedure, to provide proper monitored anesthesia care in appropriate physical conditions, and to establish healthy communication between the teams.

Traurnatic diaphragmatic rupture is a condition which the diagnosis is difficıdt. in Mis article 4 cases with traumatic diaphragmatic rupture which presented intestinal obstruction, volvulus of the dyspepsia and intraabdominal haemorhagea were evaluated retrospectively. Two cases were diagnosed prooperatively and the athers during operation. Unless probabilitiy is thought the diagnosis could easily be ınissed. Chest X-rays and other routine diagnostic ınethods were our diagnostic criteria in Mese cases. ff ultrasonographic exarnination is available diagnosing of such cases becomes accurate and easy.

Objective: Comparison of the respiratory functions were aimed in this study in female Behcet’s patients whether with or without pathological pulmonary lesions according to high resolution computerized tomography (HRCT) evalutions. Methods: 29 female patients aged between 19 to 54 (average 37.0 ± 9.5) years and as control group 20 healthy female aged 19 to 50 (40.5 ± 8.3)years were taken into the study. Patients and control group individuals were physically inspected, HRCT films were taken and pulmonary function tests (PFT) through a spirometer were determined. Patients were divided into two group according to HRCT results as HRCT (+) and HRCT (-). HRCT (+) group patients (n=11) vvere aged 28 to 54 (average 39.9 ± 8.1)years and HRCT (-) group (n=18) vvere 19 to 50 (aver­ age 35.2 ± 10.1) years. İn ali groups the determinations of FVC, FEVj, PEp25-75%’ PEF, VC, RV, FRC, DLCO and DLCO/VA values vvere performed. Analysis of the results vvere carried out by preferred variance analysis and Tukey HSD tests. Results: A statistically important difference was not observed when the PFT values vvere compared betvveen HRCT (+) and HRCT (-) patients for the obtained results and the percentage rate to expected results. When the PFT values vvere compared for both HRCT (+) and HRCT (-) patients group with the control group separately though there was no statistical difference betvveen the best values but only a statistical decrease in DLCO/VA values (p<0.01) was observed betvveen the percentage rate to espected results. Conclusion: İt may be said that though there is a pulmonary restriction in Behcet’s disease but this restriction has no relation with respiratory functions. Thus it vvill be useful to perform pulmonary function tests in both vvith or vvithout pathological findings through HRCT evaluation in order to obtain some Information about respiratory functions of Behcet’s patients. Additionally vve presume even when the results of the pulmonary functions tests are normal though some pathological changes in HRCT should be considered HRCT investigations may be useful to follovv the disease. HRCT investigations may be useful to follovv the disease.

Primary angiosarcoma of breast is a rarely seen tumor type. İt considered that tumor is developing from the pe- rilobular capillary netvvork. İt metastased with hemotagen pathvvay in early State ıt shows a poor prognosis. Fourty years old woman. Left breast mass and axillary lymphadenopathy presenced in physical examination. Biopsy was reported primer angiosarcoma of the breast. After the modified radical mastectomy, adjuvant chemotheraphy and radiotheraphy was performed. Patient was tost inpostoperative 12th month with lung and bone metastasis.

Ani işitme kaybı, hiperbarik oksijen tedavisi, prognostik faktörler

Classic kernicterus or the neurotoxicity of neonatal hyperbilirubinemia is known well, but the pathological jaundice may show itself vary different subtle neurological dysfunction at the some patients. 159 patients male 61.1 %, female 38.9 %, mean age, 24.6±13.11 months, peak bilirubin levels 20.07±4.85 mg/dl uho had therapied neona­ tal hyperbilirubinemia were studied. Newborns with serum total bilirubin levels of 15a-19.9 mg/dl in 97 patients (group I), 20-24.9 mg/dl in 41 patients (group II), 25-29.9 mg/dl in 15 patients (group III), and > 30 mg/dl in six patients (group IV) were accepted. V/e performed Denver Test ali patients and performed odiogram test 46 patients. We determined that subtle neurological abnormalities and high bilirubin levels correlate each other. However, we showed that group I and II had some problematic findings lesser degree than group III and IV. Management of jaundice in the Asian nevvborn is stili problematic and we need a lot of studies about toxic biliru­ bin levels.

Tumors In This study, anti-HCV seropozitivity was inves-tigated in 46 new diagnosed patients with different solid tumors without hepatocelluler carcinoma, which they have not received any transfusion or sur-gical operation. The positivity was evaluated using by second generation ELISA system. Patients are consist of 14 lung cancer (Ca), 7 lymphoma, 5 breast Ca, 5 hipernephroma and 15 other tumors. Anti-HCV positivity was in 5 (10.8%) of 46 pa-tients, and 4 of this positive patients were with lung Ca (4114,28.5%), and 1 was with brain Ca (113). ALT levels were normal, serum iron and iron-binding capacily were decrased in all patients, hae-moglobin and haemotocrit were also decreased in 73.9% of patients. In addition, 3 patients (6.5%) HBsAg, 21 patients (45.6%) anti HBc were found to be positive. As a result, the high positivity of anti-HBc while the HBsAg was low positive showed that there was IIBV infection, and the HCV infecton was alsa expected with the same transmission ways. Anti-HCV positivity as a marker of HCV infection-which can produce the chronic carrier state is more expected in cancer patients. They have allected immun status than normal population, but 4 of 5 posi-tivity was in Lung Ca patients is of great interest.

Dimethylsufoxide (DMS0), which was synthesi-sed in 1880's the first time and used in the chemical industty, has been being used in medikal field in an increasing rate. Its being used in organ transplantation, and ha-ving sinerjik effects on some drugs have alsa increa-sed irs effects. However, we should alsa know that it has a toxic effects. In our present study, we proposed to evaulate the toxic effect of DMSO at light microscopic level at differenı organ levels

In this report, an 8 months infant, who has a heavy dyspnea, cyanosis and mediastinal shift to left side is explained and the cliagnosis and treatment methods are discussed.

A case report of congenital diaphragmatic hernia which was diagnosed in the 14 th week of pregnancy is presented. Case Presentation: 31 year old multigravida who had 14 th week of pregnancy underwent an ultrasound examination where the fetal abdominal organs were seen in the thoracic cavity. No other sonographical pathologies were determined. The family was counseled in detail and termination of pregnancy was decided. Genetical and pathological evaluation following the misoprostol induced abortion of the pregnancy did not reveal further abnormalities. The pathological examination described a posterior defect of the diaphragma, which leads to the herniation process, as the only positive pathological finding.

Hydatid cyst is a parasitic infestation caused by Echinococcus granülosus. In this study we present a pulmonary hydatid cyst case that has radiological and bronchoscopic view like a malign mass. A 17 year-old male patient. He has cough, sputum and hemoptysis complaints. He has 10 kg weight loss in last two mounths. Thorax computed tomography showed a consolide lesion in the the right upper lobe. Fiberoptic bronchoscopy was performed in this case. There was an endobronchial hump lesion covered with necrotic tissue, in the right upper lobe anterior segment. The result of bronchoscopic biopsy was reported as ‘hydatid cyst’. We found a cystic lesion at the left liver lobe in abdominal ultsonography. Patient transferred for operation at thoracic surgery department. Hydatid cyst was rejected by operation. Hydatid cyst is usually located in the lower lobes of the lungs. Although cyst has classic radiologic, bronchoscopic findings, we should think hydatid cyst in different radiological and bronchoscopic findings too.

Abstract

Aim: We aimed to assess the changes in retinal nerve fiber layer (RNFL) and optic nerve head (ONH) in patients with chronic obstructive pulmonary disease (COPD).

Patients and Methods: Thirty patients having severe COPD and 29 age and sex-matched healthy subjects were enrolled in the study. After a detailed ophthalmic examination, the ONH and RNFL thickness measurements were taken by an optical coherence tomography (OCT) (Stratus OCT-3). Arterial blood gases (pO₂ and PCO₂) were measured and respiratory functional tests were performed for the staging of COPD patients. The OCT parameters were compared difference between the 2 groups using independent t test, while Pearson correlation analysis was performed to assess the correlations between respiratory functional tests, arterial blood gases and RNFL thickness parameters. A p value less than 0.05 was accepted as statistically significant.

Results: There were no significant differences in optic disc area, cup area and rim area between COPD and healthy subjects (p>0.05). Parameters of mean and superior quadrant RNFL thickness were found to be significantly thicker in COPD subjects (114.52±7.7 µm and 141.07 ±18.2 µm, respectively) compared to the control subjects (107.9±5.4 µm and 131.31±13.6 µm, respectively) (p<0.05). No correlation was found between pO₂ and RNFL thickness (r=-0.22, p=0.33). There was a moderate correlation between pCO₂ and superior quadrant RNFL (r= 0.53 and p=0.017), and a high negative correlation between FEV₁/FVC and superior quadrant RNFL (r=-0.76, p=0.003).

Conclusions: The increase in pCO2 and the decrease in FEV1 / FVC indicate increased hypoxia. Peripapillary RNFL loss associated with RGC death can be masked by hypoxia / ischemia-induced retinal and optic disc edema. Increased mean RNFL thickness in COPD patients was thought to be due to retinal edema associated with increased hypoxia.

Objective: The compare the effect of salpingo-oopherectomy and adnexial detorsion on the lungs of the rats which have experimentally tvvisted adnex. Material and Method: 28 wistar female rats randomly selected and divided into four groups. The group 1 is detorsioned and the group 2 has salpingo-oopherectomy 24 hours after adnexial torsion.The other group had laparatomy (group3) and the rest had only anesthesia. Twenthfour hours after the second procedure ali the rats decapitatedand their lungs evaluated microscopically and macroscopically. Findings: The detorsioned group has more pathological microscopic and macroscopic changes meaningfully. Result: Detorsion procedure incrases the pathologic macroscopic and microscopic changes at the lung

Morgagni's hernia are uncommon and it is the least common congenital diaphragmatic hernia. This condition affects the right side more frequently than the left. In adulthood, the majority of cases are asyomtomatic or produce minimal symptoms. Most Morgagni herniations in aduls are recognized ro-entgenographically. We present a case of Morgagni hernia in a 69 years old man suffering from occasioonally a pain at the right upper part of abdomen.

In the present paper, rat phrenic nerve-diaphragm preparations were used to evaluate the neuromuscular blocking activity of gentamicin, an aminoglycoside antibiotic, and of its combinations with histamine 112-recepwr blocking agents, cimetidine and famoti-dine. Gentamicin and famotidine caused partial neuro-muscular blockade when they were used alone, but cimetidine had no effect. There was no interactions between giyen histamine H2-receptor blocking drugs and reduced concentration of gentamicin (10-4M) which does not exert any neuromuscular blockade. However, when the ineffective doses of cimetidine or famotidine are added in the medium, partial inhibi-tion caused by 10-2 M gentamicin attained to complete blockade. This effect can be reversed with the addition of calcium chloride. These results Show that, if the partial blockade is present, histamine H2-receptor blocking agents can greatly compromise the neuromuscular transmission.

Purpose: It was aimed to present the clinical and functional results of the patients who underwent tumor resection and endoprosthetic reconstruction due to malignant tumor around the elbow.

Methods: 14 patients who underwent tumor resection and endoprosthetic reconstruction due to malignant tumor in the elbow circumference between 2011-2018 in our clinic were included in the study. While 4 of the patients were primary tumors (1 fibromixoid sarcoma, 1 leimyosarcoma, 1 multiple myeloma and 1 ewing sarcoma), 10 were distant organ metastases (4 breast cancer, 3 lung cancer, 1 stomach cancer, 1 renal cell cancer and 1 thyroid cancer). Musculoskeletal Tumour Society (MSTS) score and Mayo elbow performance score (MEPS) and survival were evaluated.

Results: The minimum follow-up period of the patients was 7 months, and the maximum follow-up period was 55 months. The mean MEPS score of the patients was 67.5 ± 12.0 (range, 45-90), and the mean of the MSTS score was 19.4 ± 2.3 (range, 16-24). Recurrence occurred at follow-up in 3 patients and exitus at follow-up in 7 patients. In this study, the median survival time of the patients was 44 months. The 1-year survival rate was 70.1% while the 3-year survival rate was 54.5%.

Conclusion: Pain and functional results are satisfactory in patients who undergo tumor resection and endoprosthetic reconstruction due to malignant tumor around the elbow. In the future, studies with larger patient series are needed.

Aim: We aimed to retrospectively analyze and present the findings of patients diagnosed with esophageal
cancer and staged using 18F-Fluorodeoxyglucose (18F-FDG) Positron Emission Tomography/Computed
Tomography (PET/CT) imaging.
Patients and Methods: Thirty-seven patients diagnosed with esophagus who were staged with 18F-FDG
PET/CT in our hospital between February 2015 and February 2020 were included in this study. Patients'
age, gender, localization of the primary tumor and 18F-FDG PET/CT maximum standardized uptake value
(SUVmax), findings of metastases to mediastinal, abdominal and cervical lymph nodes, lung, liver, bone and
other areas were retrospectively evaluated as.
Results: The meanage of the patients was 66,97 ± 14,54 years. 20 patients (54%) were male, 17 patients
(46%) were female. 10 patients (27%) had upper esophagus tumors, 23 patients (62%) had lower esophagus
tumors, 4 patients had middle esophageal tumors (11%). The pathological diagnosis of 23 patients was
squamous cell ca, 14 patients were adeno ca. The mean of primary tumor SUV max was measured as 14,09
± 6,36 in all patients. The mean primary tumor SUVmax of the patients diagnosed with squamous ca was
14,51 ± 6,63, and the mean of primary tumor SUV max of the patients diagnosed with adeno ca was found to
be 13,40 ± 6,03. Progression was observed in 7 of 9 patients whose treatment and follow-ups were continued
in our hospital, and regression was observed in 2 of them.
Conclusion: In the initial staging of patients diagnosed with esophageal ca, 18F-FDG PET/CT is an
increasingly useful imaging method. Our study supports this.

The most common therapeutic method for early stage distal esophageal cancers and proximal stomach
cancer is surgery. One of the challenges in esophageal surgery is to maintain gastrointestinal continuity.
The neoesophagus is transferred from the posterior, mediastinal, or retrosternal areas to the cervical
region. A 61-year-old male patient with esophageal cancer had received transhiatal total gastrectomy,
distal esophagectomy, and Roux-en-Y esophagojejunostomy. Right thoracotomy had been performed due
to anastomotic leak with the esophageal stump left behind. Left thoracotomy and metastasectomy were
also performed due to lung metastasis. The left colon was transpositioned from the presternal area to
the cervical region for reconstructive purposes. Physicians should bear in mind that the conduit can be
advanced in the presternal area as the last resort for its localization in esophageal surgery. The aim of this
study was to present, along with literature review, the case of a patient with distal esophageal cancer for
whom presternal colonic transposition was performed with the es ophageal stump left behind.

The lungs provide oxygenation of the organism and the removal of carbon dioxide from the body. The maintenance of myth base balance and the regulation of arterial concentration of many vasoactive hormones are provided by this organ. The lungs work under normal mechanical stress and against a low arterial pressure system, the highly developed lymphatic system allows it to perform its functions more easily. However, it has been demonstrated that if the lungs are under more stress than their capacity, a series of events can develop that can affect all the systems of the organism and ultimately lead to death. This condition, which can develop for many etiological reasons, is called Respiratory Distress Syndrome (RDS).

Ewing's sarcorna nıimicking an unilateral in-1ectious sat and that cause to metastasize at the lung and brain is reported.