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Öğe Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital(Wiley-Hindawi, 2022) Akatli, Ayse Nur; Ulutas, Hakki; Samdanci, Emine Turkmen; Celik, Muhammet RehaBackground. Bronchiectasis is still a challenging chronic lung disease in developing countries. Patients with bronchiectasis can also have pulmonary hypertension. There are sparse data on the prevalence of pulmonary hypertension in patients with bronchiectasis. Materials and methods. Archived H&E-stained slides of 141 patients histopathologically diagnosed with bronchiectasis were reevaluated. Cases were categorized into 4 subgroups based on histology: tubular, varicose, follicular, and cystic. In addition, concomitant histopathological changes were also reevaluated. For patients with available CT sections, main, right, and left pulmonary artery (PA) diameters and PA/aorta ratio were measured with regard to pulmonary hypertension. Results. Of the cases, 70% (n = 89) were female and 30% (n = 52) were male, with a mean age of 36.58 in females and 33.84 in males. Histopathologically, 43% (n = 68) of the cases showed follicular, 37% (n = 59) showed varicose, 35% (n = 56) showed tubular, and 28% (n = 45) showed cystic bronchiectasis morphology. All cases showed chronic inflammation, fibrosis, muscle destruction, and cartilage destruction. Aspergillus were present in 11% of the cases showing cystic morphology. Approximately 17% of the cases (n = 24) were found to have neuroendocrine cell proliferations. In cases with medial hypertrophy, a statistically significant increase in the left pulmonary artery diameter was radiologically determined. Conclusions. Medial hypertrophy was found to be significant with regard to indicating a radiological increase in left pulmonary artery diameter. Vascular changes observed in bronchiectasis cases and the presence of neuroendocrine cell proliferations should be specified in pathology reports, and aspergilloma should be carefully investigated in cases with predominant cystic morphology.Öğe The esophageal rapunzel syndrome: a case of a trichobezoar in the esophagus(Pagepress Publ, 2023) Agar, Mehmet; Celik, Muhammet Reha; Ulutas, Hakki; Gulcek, Ilham; Kalkan, MuhammedRapunzel syndrome is a form of trichobezoar, a rare form of bezoar, especially seen in individuals with hair pulling (trichotillomania) and hair eating (tricophagia) habits, that extends from the pylorus into to the duodenum, jejunum and even the colon. We report the case of a 37-year-old woman with a trichobezoar in the esophagus, causing esophageal rupture that required an urgent surgical intervention.Öğe Extracorporeal Membrane Oxygenation After Living-Related Liver Transplant(Baskent Univ, 2015) Gedik, Ender; Celik, Muhammet Reha; Otan, Emrah; Disli, Olcay Murat; Erdil, Nevzat; Bayindir, Yasar; Kutlu, RamazanVarious types of extracorporeal membrane oxygenation methods have been used in liver transplant operations. The main indications are portopulmonary or hepatopulmonary syndromes and other cardiorespiratory failure syndromes that are refractory to conventional therapy. There is little literature available about extracorporeal membrane oxygenation, especially after liver transplant. We describe our experience with 2 patients who had living-related liver transplant. A 69-year-old woman had refractory aspergillosis pneumonia and underwent pumpless extracorporeal lung assist therapy 4 weeks after liver transplant. An 8-month-old boy with biliary atresia underwent urgent liver transplant; he received venoarterial extracorporeal membrane oxygenation therapy on postoperative day 1. Despite our unsuccessful experience with 2 patients, extracorporeal membrane oxygenation and pumpless extracorporeal lung assist therapy for liver transplant patients may improve prognosis in selected cases.Öğe Foreign-body aspiration mimicking asthma in pre-school age group: A case report(2019) Ozbey, Mehmet Yavuz; Topal, Erdem; Ulutas, Hakki; Celik, Muhammet RehaÖğe Histopathological evaluation of autopsy cases with isolated pulmonary fat embolism (IPFE): is cardiopulmonary resuscitation a main cause of death in IPFE?(Dove Medical Press Ltd, 2019) Samdanci, Emine Turkmen; Celik, Muhammet Reha; Pehlivan, Sultan; Celbis, Osman; Turkkan, Dilhan; Kara, Dogus Ozdemir; Pamukcu, EsraBackground: Fat embolism (FE) may develop following many traumatic and atraumatic clinical conditions; however, fewer data exist regarding the occurrence of isolated pulmonary FE (IPFE). Cardiopulmonary resuscitation (CPR) is an emergency procedure for maintaining blood circulation and oxygenation during cardiac arrest. In this study, we aimed to evaluate the association of CPR with IPFE in autopsy cases. Methods: A total 402 cases among 4,118 autopsies were diagnosed with IPFE, and the medical background of these cases was retrospectively evaluated. Diagnosis of FE and FE grading were performed with histopathological examinations of postmortem tissue samples, and injury-severity scores of traumatic cases were assessed. Data of traumatic and atraumatic cases were statistically compared. Results: Of the IPFE cases, 298 (741%) were male and 104 (25.9%) female, with overall mean age 53.7 (2-99) years. Causes of death of studied subjects were traumatic for 302 (75.1%) and atraumatic reasons for 100 (24.9%) cases. CPR was performed for 277 cases of which 177 (63.9%) were traumatic and 100 (36.1%) were non-traumatic. In comparison to traumatic cases, significantly higher CPR frequency was determined in atraumatic IPFE (P=0.001). High grade FE in the traumatic cases, and mild-moderate grade of FE in the nontraumatic cases were found statistically significant (P=0.001). Conclusion: This study indicates that CPR may be one of the leading factors in the development of IPFE in atraumatic conditions, and this procedure was related to mild-moderate IPFE manifestations. Regardless of whether conditions were traumatic or atraumatic, in patients who survive following CPR for manifest ventilation/perfusion problems, it should be remembered that IPFE may have developed due to CPR.Öğe Management of spontaneous pneumothorax in patients with COVID-19(Oxford Univ Press, 2022) Ulutas, Hakki; Celik, Muhammet Reha; Gulcek, Ilham; Kalkan, Muhammed; Agar, Mehmet; Kilic, Talat; Gulcek, EmineOBJECTIVES: The coronavirus disease 2019 (COVID-19) pneumonia may cause cystic features of lung parenchyma which can resolve or progress to larger blebs. Pneumothorax was more likely in patients with neutrophilia, severe lung injury and a prolonged clinical course. The timely diagnosis and management will reduce COVID-19-associated morbidity and mortality. METHODS: We present 11 cases of spontaneous pneumothorax managed with chest tube thoracostomy or high-dose oxygen therapy. Isolated spontaneous pneumothorax was detected in all cases. RESULTS: Eight cases were male and 3 cases were female. There were bilateral ground-glass opacities or pulmonary infiltrates in the parenchyma of the 10 cases. We detected neutrophilia, lymphopaenia and increased C-reactive protein, Ferritin, lactate dehydrogenase, D-Dimer, interleukin-6 levels in almost all cases. Chest tube thoracostomy was sufficient to treat pneumothorax in our 9 of case. In 2 cases, pneumothorax healed with high-dose oxygen therapy. Favipiravir and antibiotic treatment were given to different 10 patients. In our institution, all patients with COVID-19 infection were placed on prophylactic or therapeutic anticoagulation, unless contraindicated. The treatments of patients diagnosed with secondary spontaneous pneumothorax during the pandemic period and those diagnosed with secondary spontaneous pneumothorax in the previous 3 years were compared with the durations of tube thoracostomy performed in both groups. CONCLUSIONS: The increased number of cases of pneumothorax suggests that pneumothorax may be a complication of COVID-19 infection. During medical treatment of COVID-19, pneumothorax may be the only reason for hospitalization. Although tube thoracostomy is a sufficient treatment option in most cases, clinicians should be aware of the difficulties that may arise in diagnosis and treatment.Öğe Primary pulmonary glomangioma(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2017) Celik, Muhammet Reha; Sahin, Nurhan; Akatli, Ayse Nur; Ulutas, HakkiGlomangiomas are benign soft tissue tumors derived from the glomus bodies surrounding arteriovenous anastomoses. In this article, we report a 40-year-old female patient admitted to our clinic due to chest pain whose computed tomography of the chest revealed a solitary lesion of 4 cm in diameter. The lesion was removed with video-assisted thoracoscopic wedge resection. The histopathological diagnosis was reported as glomangioma. Glomus bodies almost never exist in the lung parenchyma; thus, pulmonary glomangiomas are extremely rare lesions. They can easily be confused with more common primary or metastatic lesions of the lungs. Risk of recurrence is low for this tumor and sublobar complete resection is the treatment of choice for definitive diagnosis and curative treatment.Öğe The Role of CD90 in the Differential Diagnosis of Pleural Malignant Mesothelioma, Pulmonary Carcinoma and Comparison with Calretmm(Frontiers Media Sa, 2017) Sahin, Nurhan; Akatli, Ayse Nur; Celik, Muhammet Reha; Ulutas, Hakki; Samdanci, Emine Turkmen; Colak, CemilPleural Malignant Mesothelioma (MM) is a fatal disease that has been associated with asbestos exposure. Differential diagnosis between the pleural infiltration of pulmonary carcinomas and MM is rather difficult particularly for epitheloid type mesothelioma. We aimed to investigate the utility of CD90, a cancer stem cell marker, in the differential diagnosis of MM and lung carcinoma, its prognostic significance and compare its value with that of Calretinin. Ninety pathology specimens including MM (n:30), pulmonary adenocarcinoma (n:30) and pulmonary squamous cell carcinoma (n:30) were used in this study. Immunohistochemical comparision of CD 90 and Calretinin was made in all groups. Calretinin was positive in 20 cases with MM (64.5 %), and was negative in 10 (32.3 %). CD 90 was positive in 25 of these cases (80 %) and negative in 5 (16 %). On the other hand pulmonary adenocarcinomas and squamous cell carcinomas showed positivity with CD90, 63,6 % and 73 %, respectively. We think that CD 90 has no place in the differential diagnosis between mesothelioma and pulmonary carcinoma because of the low specificity in spite of the high sensitivity.Öğe The role of current surgical therapy for pediatric/adolescent and adult patients with bronchiectasis(Baycınar medıcal publ-baycınar tıbbı yayıncılık, ornek mh dr suphı ezgı sk saray apt no 11 d 6, atasehır, ıstanbul 34704, turkey, 2017) Ulutas, Hakki; Celik, Muhammet Reha; Kuzucu, AkinBackground: This study aims to compare clinical manifestations, surgical indications, surgical procedures, postoperative complications, and outcomes of surgical treatment in pediatric and adult patients with bronchiectasis. Methods: Between January 2000 and December 2013, a total of 99 patients (40 males, 59 females; mean age 33.3 years; range 10 to 67 years) who underwent surgery for bronchiectasis at the Department of Thoracic Surgery were retrospectively analyzed. Group 1 (n=28) were pediatric patients (<= 18 years) and group 2 (n=71) were adult patients (>18 years). Clinical symptoms, criteria surgical treatments applied, surgical treatment approaches, postoperative complications, the length of hospital stay, and treatment outcomes were evaluated. Results: In both groups, the most common symptom was productive cough, followed by recurrent infections. There were no significant differences in the frequency of these symptoms between the groups. In total, 104 surgeries were performed. Of 29 surgeries in group 1, 26 were thoracotomies and three were video-assisted thoracoscopic surgery. Of 75 surgeries in group 2, 60 were thoracotomies and 15 were video-assisted thoracoscopic surgery. Postoperative complications were seen in eight operations (27.6%) in group 1 and 18 operations (24%) in group 2. There was no intra- or postoperative mortality. All 28 patients in group 1 showed improvement after surgery, while 23 outcomes (82.1%) were rated excellent (complete remission) and five outcomes (17.9%) were rated improved (reduced symptoms). In group 2, 63 outcomes (88.7%) were excellent and seven outcomes (9.9%) were rated improved; however, one patient (1.4%) showed no improvement. Conclusion: In selected cases, surgical treatment for bronchiectasis is satisfactory and associated with acceptable mortality and morbidity rates, irrespective of the age of the patient. Based on our study results, surgery can cure this condition and can improve the quality of life, even when not curative.Öğe Surgery for Pulmonary Hydatidosis in Turkey in 2014: A Nationwide Study(Aves, 2019) Gulhan, Sakir Erkmen; Kilicgun, Ali; Samancilar, Ozgur; Altinok, Tamer; Kutluk, Ali Cevat; Baysungur, Volkan Selami; Celik, Muhammet RehaOBJECTIVES: Turkey remains among the countries where hydatid disease is endemic. In this study, it was aimed to determine the number of operations performed for the treatment of pulmonary hydatid disease in Turkey during 2014 and to present the distribution of these operations according to the different regions of the country. MATERIALS AND METHODS: The Turkish Thoracic Society Thoracic Surgery Study Group connected with the thoracic surgeons in each city through telephone. A data set was sent by email. The age, sex, contact with animals that might be a risk of gaining the hydatid disease, the side of the disease, the type of surgical method, other organ involvement were recorded and collected from each data set to form the final data, and the results were evaluated. Turkey comprises of 81 cities that are grouped in seven different regions. The number of operations was calculated for each city and region to present the distribution. RESULTS: Overall, 101 centers from 81 cities were considered in the study. A total of 715 pulmonary hydatid cyst operations were performed in 690 patients during the study period. The most common operation technique was cystotomy and capitonnage through thoracotomy (76%). The highest incidence rate of operated patients was in the Eastern Anatolian Region (2.15 patients per 100 000 person-years). CONCLUSION: Pulmonary hydatid disease still has a high incidence rate particularly in the southeast and east of Turkey, which are mainly rural areas and where stockbreeding is very common. Cystotomy and capitonnage is still the most common surgical method used to treat pulmonary hydatid cysts. Preventive methods should be performed strictly in these cities and regions to decrease the risk of infection.Öğe Thymic Seminoma with Regressive Changes Obscured by Granulomatous Reaction(Coll Physicians & Surgeons Pakistan, 2022) Akatli, Ayse Nur; Samdanci, Emine; Celik, Muhammet Reha; Alan, Saadet; Ulutas, Hakki; Akpolat, NusretPrimary thymic seminoma is an exceedingly rare tumour. There are few case reports about mediastinal thymic seminoma accompanied by secondary changes. We report a case of a 29-year male admitted to our hospital because of chest pain and dyspnea for 8 months. Computed tomography of the thorax revealed hypodense, solid masses showing calcification and cystic degeneration in the anterior mediastinum. Histopathological examination of the resected specimen revealed a diagnosis of thymic seminoma with regressive and reactive changes. The present case was unique in its presentation as a primary seminoma showing combination of cystic degeneration, follicular hyperplasia, fibrosis, calcification and granulomatous reaction in one case. High level of suspicion is necessary to identify seminomas in a thymic lesion accompanied by secondary changes. Excluding the possibility of metastasis from testicular seminoma is very important before making this diagnosis.
