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Öğe Effects of thymoquinone and curcumin on the regeneration of rat livers subject to 70% hepatectomy(ACTA CIRURGICA BRASILEIRA, ALAMEDA RIO CLARO, 179-41, SAO PAULO, SP 01332-010, BRAZIL, 2018) Yılmaz, MehmetPurpose: To investigate thymoquinone, curcumin and a combination of these two drugs were effective or not at the growth of liver. Methods: Forty female Wistar-Albino rats distributed into five groups of eight rats each, control, thymoquinone, curcumin, and thymoquinone/curcumin groups. Pathological specimens were studied using the Ki-67 Proliferation Index(PI); and arginase(Arg), tissue plasminogen activator(tPA), ceruloplasmin(Cer) and nitric oxide(NO) were studied in biochemical analysis. Results: Our results showed that Ki-67 proliferation index was low in Groups 1. The proliferation coefficient was significantly higher in the Group 2 and Group 4 than in the Group 1 and Group 3.(P < 0.001 between Groups 1 and 2, 1 and 4, and 3 and 4). There was no difference between Groups 2 and 4 (P = 1). The results of the biochemical Arg, tPA and Cer test showed statistically between the Group 1 and Group 2. NO showed significant differences Group 1 and 3. Conclusions: Thymoquinone and curcumin both have known positive effects on the organism. Histological and biochemical tests showed that thymoquinone is more effective than curcumin.Öğe Assessment of clinical and pathological features of patients who underwent thyroid surgery: A retrospective clinical study(BAISHIDENG PUBLISHING GROUP INC, 8226 REGENCY DR, PLEASANTON, CA 94588 USA, 2018) Akbulut, Sami; Çolak, CemilTo evaluate whether there was any correlation between the clinical parameters and final pathological results among patients who underwent thyroid surgery. METHODS We retrospectively analyzed parameters, including age, sex, complete blood cell count parameters, nodule diameter, nodule localization, thyroid function testing, and pathology reports, in patients who underwent thyroid surgery. The patients were divided into malignant (n = 92) and benign (n = 413) groups depending on the final pathological results. Both groups were compared for demographic and clinical parameters. The Kolmogorov-Smirnov normality test was used to determine if the quantitative variables had a normal distribution. The nonparametric Mann-Whitney U test was used to compare quantitative data that were not normally distributed, and Pearson's chi-squared test was used to compare the qualitative data. The correlation between the final pathological results and fine-needle aspiration biopsy findings was calculated using the cross-tabulation method. RESULTS This study included 406 women and 99 men aged between 15 and 85 years. No significant differences were found between the groups with respect to age, sex, white blood cell count, neutrophil count, lymphocyte count, thrombocyte count, red cell distribution width, platelet distribution width, mean platelet volume, platecrit, nodule localization, and thyroid function testing. On the other hand, there were significant differences between the groups with respect to nodule size (P = 0.001), cervical lymphadenopathy (P = 0.0001) and nodular calcification (P = 0.0001). Compared with the malignant group, the benign group had a significantly greater nodule size (35.4 mm vs 27.6 mm). The best cut-off point (<= 28 mm) for nodule size, as determined by the receiver operating characteristic curve, had a sensitivity and specificity of 67.7% and 64.4%, respectively. The correlation between fine-needle aspiration biopsy and the final pathological results was assessed using the cross-table method. The sensitivity and specificity of fine-needle aspiration biopsy were 60% and 98%, respectively. CONCLUSION This study showed that significant differences existed between the malignant and benign groups with regard to nodule size, cervical lymphadenopathy, and nodular calcification.Öğe A revised treatment approach for hospitalized patients with eosinophilic and neutrophilicexacerbations of chronic obstructive pulmonary disease(Bılımsel tıp publıshıng house, bukres sokak no 3-20 kavaklıdere, ankara, 00000, turkey, 2018) Aksoy, Emine; Gungor, Sinem; Agca, Meltem Coban; Ozmen, Ipek; Duman, Dildar; Kocak, Nagihan Durmus; Akturk, Ulku Aka; Tuncay, Eylem; Salturk, Cuneyt; Yalcinsoy, MuratOBJECTIVES: The choice of treatment according to the inflammation type in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) has been of recent interest. This study investigated the role of novel biomarkers, hospital outcomes, and readmission rates in the first month in patients with eosinophilic or neutrophilic AECOPD. MATERIALS AND METHODS: We conducted a retrospective observational cohort study in a Chest Teaching Hospital with hospitalized AECOPD patients. Subjects' characteristics, hemogram results, C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), platelet/ lymphocyte ratio (PLR), platelet/mean platelet volume (PLT/MPV), length of hospital stay, mortality, and steroid use were recorded. Eosinophilic AECOPD defined as peripheral blood eosinophilia (PBE) was >2% and neutrophilic AECOPD as PBE Q%. Readmission within 28 days of discharge was recorded. RESULTS: Of 2727(31.5% females) patients, eosinophilic AECOPD was found in 510 (18.7%) patients. Leucocytes, CRF,' NLR, and PLR were significantly higher in neutrophilic AECOPD than in eosinophilic AECOPD (p<0.001). Steroid use and mortality rate were 45% and 0.6% in eosinophilic AECOPD and 71%, and 1.4% in neutrophilic AECOPD, respectively (p=0.001, p=0.19). Age >75 years, albumin <2.5 g/dL, CRP >50 mg/dL, and PLT/MPV <20x103 were found to be risks factors for hospital mortality (p<0.05 each). Readmission rates within 28 days of discharge were 5% (n=136), and this rate was higher in eosinophilic AECOPD patients not taking steroids (p<0.001). CONCLUSION: NLR, PLR, and CRP levels were higher in neutrophilic AECOPD compared with eosinophilic AECOPD. These markers decreased with treatment in neutrophilic AECOPD. A PLT/MPV ratio of <20x103 resulted in an increased mortality rate. Thus, appropriate steroid therapy may reduce readmission rates in the first 28 days after discharge in eosinophilic AECOPD.Öğe Pseudoangiomatous stromal hyperplasia of the breast presenting as a giant breast tumor a case report(J Breast Health, 2015) Kutlutürk, Koray; Usta, Sertaç; Ünal, Bülent; Karadağ, Neşe; Akatlı, Ayşe NurPseudoangiomatous stromal hyperplasia (PASH) of the breast is a benign proliferative lesion of mammary stroma. It is identified as stromal cleavage surrounded by spindle-shaped stromal cells histomorphologicaly. Generally, it is determined in premenopausal women incidentally during breast biopsy. Clinically, it is rarely emerges as a palpable mass. PASH may be confused with low-grade angiosarcoma, hamartomas and phyllodes tumors in histopathological examination. Here, we report a giant left breast lesion that caused breast asymmetry and pain, and treated by total excision of the mass. The patient was a 39 years old women. Histopathologic examination of the specimen was evaluated as PASH. No additional medical treatment and clinical follow-up was recommended to patient. Within four months of the patient fallow-up, no problem occured.Öğe Pleuropulmonary blastoma report of a case presenting with spontaneous pneumothorax(European journal of cardio-thoracic surgery, 2001) Kuzucu, Akın; Soysal, Ömer; Yakıncı, Mehmet Cengiz; Aydın, Nasuhi EnginA 21 /2-year-old boy was referred to the Department of Thoracic Surgery with pneumothorax. He had a history of dif®culty in breathing, cough and fever for the last 6 months. Prior to admission, he had undergone antibiotic treatment for pneumonia, which was diagnosed on chest radiogram. He was dyspneic and had leukocytosis. Chest radiograms showed right tension pneumothorax and a cystic mass lesion in the right lower lobe, the radiologic appearance simulating an air crescent sign. A chest tube was inserted into the right hemithorax, resulting in lung expansion. Thorax CT con®rmed a large solid mass with necrotic areas, ®lling the right inferoposterior hemithorax. Magnetic resonance examination revealed a supradiphragmatic, suggestively extraparenchymal, mass compressing the lower lobe. Bronchoscopy was not performed since the tumor was peripherally located. At thoracotomy, a predominantly solid and partially necrotic mass with extraparenchymal extension was found to originate from the visceral pleura, extending posteriorly to the mediastinum and inferiorly to the diaphragm. The mass involved the diaphragmatic surface of the posterobasal segment through a narrow base. Although ®rm adhesions were present, involvement of the parietal pleura was not observed. The mass was removed completely with local excision and wedge resection. Lobectomy was not required. The resected 7 £ 7 £ 3 cm mass was histopathologically evaluated to present with morphological characteristics of pleuropulmonary blastoma (PPB). The patient did well in the postoperative period and was discharged on the 7th postoperative day. Eight courses of cisplatin (100 mg/m2 ) and etoposide (100 mg/m2 ) were administered postoperatively at an oncology center. He is well and free of recurrence at 10 months following surgery. PPB is de®ned as a distinctive pulmonary and/or pleural tumor of childhood with blastomatous and sarcomatous features without any epithelial component, differentiating it from the classical adult type pulmonary blastoma [1]. It is pathologically divided into cystic, solid and mixed types [2]. PPB is considered within the category of disembryonic neoplasms such as Wilms' tumor, neuroblastoma and hepatoblastoma [1]. The etiology and predisposing factors are unclear. However, PPB arising in the presence of cystic pulmonary disease have been reported [1]. In the present case, there was no cystic remnant within the tumor and radiological cystic appearance was principally due to tumor necrosis. The common presenting symptoms in PPB are respiratory distress, fever, chest pain, cough, anorexia and malaise [3]. PPB may also present with pneumothorax. Pneumothorax was reported in those cases associated with cystic pulmonary disease [4,5]. In the present case, tension pneumothorax might have resulted from spontaneous rupture of the tumor. The recommended initial treatment for PPB has been complete surgical excision. However, invasion of the surrounding structures and extreme friability of the tumor may prevent complete excision. The prognosis is usually poor. Gender, pathological subtype, tumor size, extent of surgical resection, presence of necrosis and adjuvant treatments such as radiotherapy and chemotherapy have been reported not to in¯uence survival signi®cantly. The best indicators of long-term survival are the presence of parenchymal involvement alone and the absence of pleural or mediastinal involvement [3].Öğe Chest injury due to blunt trauma(European journal of cardio-thoracic surgery, 2003) Liman, Şerife Tuba; Kuzucu, Akın; Taştepe, Abdullah İrfan; Ulaşan, Neslihan; Topçu, SalihGiven its importance in trauma practice, we aimed to determine the pathologies associated with blunt chest injuries and to analyze the accurate identification of patients at high risk for major chest trauma. Methods: We reviewed our experience with 1490 patients with blunt chest injuries who were admitted over a 2-year period. Patients were divided into three groups based on the presence of rib fractures. The groups were evaluated to demonstrate the relationship between the number of rib fractures and associated injuries. The possible effects of age and Injury Severity Score (ISS) on mortality were analyzed. Results: Mean hospitalization time was 4.5 days. Mortality rate was 1% for the patients with blunt chest trauma, 4.7% in patients with more than two rib fractures and 17% for those with flail chest. There was significant association between the mortality rate and number of rib fractures, the patient’s age and ISS. The rate of development of pneumothorax and/or hemothorax was 6.7% in patients with no rib fracture, 24.9% in patients with one or two rib fractures and 81.4% in patients with more than two rib fractures. The number of rib fractures was significantly related with the presence of hemothorax or pneumothorax. Conclusion: Achieving better results in the treatment of patients with chest wall injury depend on a variety of factors. The risk of mortality was associated with the presence of more than two rib fractures, with patients over the age of 60 years and with an ISS greater than or equal to 16 in chest trauma. Those patients at high risk for morbidity and mortality and the suitable approach methods for them should be acknowledged.Öğe The role of surgery in chest wall tuberculosis(Interactive cardiovascular and thoracic surgery, 2004) Kuzucu, Akın; Soysal, Ömer; Günen, HakanChest wall tuberculosis is a rare entity and its clinical presentation may resemble a pyogenic abscess or chest wall tumor. The role of surgery in the diagnosis and treatment of chest wall tuberculosis is still controversial. During a 6-year period (1997–2002), six cases with cold abscesses of chest wall were managed in our clinic. Clinical presentation, diagnostic workup, treatment strategies, and results of medical and surgical treatment were retrospectively reviewed. There were four male and two female patients. All but one had a fluctuating and abscess-like chest wall mass. Pleura and mediastinal or chest wall lymph nodes were also involved in three patients. Before the debridement and abscess drainage, the diagnosis was not confirmed in any of our patients except one. All received a four-drug antituberculous regimen for 6–12 months postoperatively and improved clinically and radiologically. Surgical intervention and histological examination are usually necessary for the treatment and to confirm the diagnosis in chest wall tuberculosis. Antituberculous medical treatment and adjunctive surgery are quite effective in this process.Öğe Complicated hydatid cysts of the lung clinical and therapeutic issues(Annals of thoracic surgery, 2004) Kuzucu, Akın; Soysal, Ömer; Özgel, Mehmet; Yoloğlu, SaimThe clinical presentation and the preoperative and postoperative complications associated with pulmonary hydatid cysts depend on whether the cyst is intact or ruptured. The aim of this study was to review the problems encountered in treating ruptured pulmonary hydatid cysts and to highlight the risks associated with chemotherapy and the delay of surgical treatment in pulmonary hydatid disease. Methods. The medical records for 67 patients of pulmonary hydatidosis were retrospectively investigated. The patients were divided into two groups based on whether the pulmonary cyst was intact (group 1, n 34) or complicated (group 2, n 33). A complicated cyst was defined as one that had ruptured into a bronchus or into the pleural cavity. All patients were treated surgically. Data related to symptoms, preoperative complications, surgical procedures performed, postoperative morbidity, hospitalization time, and cyst recurrence were collected from each individual’s records, and the group findings were compared. Results. In most cases of intact pulmonary hydatid cysts, the lesions were either incidental findings or the patient had presented with cough, dyspnea and chest pain. In addition to these symptoms, the patients with complicated cyst had presented with problems such as expectoration of cystic contents, repetitive hemoptysis, productive sputum, and fever. The differences between the groups with respect to the rates of preoperative complications and postoperative morbidity, frequency of decortication, and hospital stay were statistically significant (p < 0.05). Conclusions. Surgery is the primary mode of treatment for patients with pulmonary hydatid disease. Complicated cases have higher rates of preoperative and postoperative complications and require longer hospitalization time and more extensive surgical procedures than uncomplicated cases. This underlines the need for immediate surgery in any patient who is diagnosed with pulmonary hydatidosis.Öğe Idiopathic laryngotracheal stenosis effective definitive treatment with laryngotracheal resection(Journal of thoracic and cardiovascular surgery, 2004) Ashiku; Simon K.; Kuzucu, Akın; Grillo; Hermes C.; Wright; Cameron D.; Wain; John C.; Lo; Bruce; Mathisen; Douglas J.Little was known about idiopathic laryngotracheal stenosis when it was first described. We have operated on 73 patients with idiopathic laryngotracheal stenosis, have confirmed its mode of presentation and response to surgical therapy, and have established long-term follow-up. Methods: Charts of 73 patients treated surgically for idiopathic laryngotracheal stenosis between 1971 and 2002 were retrospectively reviewed. Results: All patients were treated with a single-staged laryngotracheal resection, with (36/73) and without (37/73) a posterior membranous tracheal wall flap. Nearly all were women (71/73), with a mean age of 46 years (range, 13-74 years). Twenty-eight (38%) of 73 had undergone a previous procedure with laser, dilation, tracheostomy, T-tube, or laryngotracheal operations. After laryngotracheal resection, the majority of patients (67/73) were extubated in the operating room, and 7 required temporary tracheostomies, only 1 of whom was among the last 30 patients. All were successfully decannulated. There was no perioperative mortality. Principal morbidity was alteration of voice quality, which was mild and tended to improve with time. Sixty-seven (91%) of 73 patients had good to excellent long-term results with voice and breathing quality and do not require further intervention for their idiopathic laryngotracheal stenosis. Conclusion: Idiopathic laryngotracheal stenosis is an entity that occurs almost exclusively in women and is without a known cause. It is not a progressive process, but the timing of the operation is crucial. Single-staged laryngotracheal resection is successful in restoring the airway while preserving voice quality in more than 90% of patients. Protective tracheostomy is now rarely required (1/30). Long-term follow-up shows a stable airway and improvement in voice qualityÖğe Dieulafoys disease a cause of massive hemoptysis that is probably underdiagnosed(Annals of thoracic surgery, 2005) Kuzucu, Akın; Gürses, İclal; Soysal, Ömer; Kutlu, Ramazan; Özgel, MehmetDieulafoy’s disease is a vascular anomaly characterized by the presence of a tortuous dysplastic artery in the submucosa. The condition was first described as a cause of gastrointestinal bleeding in the stomach. Recently, there have been a few reports of Dieulafoy’s disease involving the respiratory tract. Herein, we report 2 patients with massive hemoptysis who were treated with surgical resection and later diagnosed with bronchial Dieulafoy’s disease.Öğe Optimal timing for surgical treatment to prevent recurrence of spontaneous pneumothorax(Surgerytoday, 2006) Kuzucu, Akın; Soysal, Ömer; Ulutaş, HakkıPersistent air leakage and recurrence are the most common indications for the surgical treatment of spontaneous pneumothorax; however, the optimal timing for surgery is still unclear. Methods. The subjects of this study were 90 patients treated for either primary spontaneous pneumothorax (PSP; n = 58) or secondary spontaneous pneumothorax (SSP; n = 32). We compared the incidence of prolonged air leak, the rate of recurrence of pneumothorax, the time from the first episode of pneumothorax to recurrence, and the postoperative complications in the two groups. We also analyzed the recurrence rate after treatment with observation and tube drainage versus surgery. Results. Seventy-three patients were treated with tube thoracostomy or oxygen therapy for the first episode of pneumothorax. Surgery was performed in 32 patients; for the first episode of pneumothorax in 17 and for the second or third episode in 15. Postoperative complications developed in six (18.7%) patients and 24 of 73 patients who did not undergo thoracotomy suffered recurrence. The incidence of a second episode was 32.9% and the incidence of a third episode in the 18 patients who suffered recurrence after conservative treatment was 61.1%. None of the patients who underwent surgery suffered recurrence. Conclusions. Tube thoracostomy is still the treatment of choice for first-time spontaneous pneumothorax. However, because the incidence of a third episode of pneumothorax after conservative treatment is high, surgical treatment should always be considered for patients with recurrence. In short, surgical intervention is safe and effective and minimizes the chance of recurrence of both PSP and SSP.Öğe Parasitic disease of the respiratory tract(Current opınıon ın pulmonary medicine, 2006) Kuzucu, AkınThe human pulmonary system can be affected by a variety of parasites. This review focuses on the most common parasitic infestations involving the lung, except for protozoon disease. Recent findings In many parasitic lung conditions, the clinical manifestations and the imaging findings are non-specific and can make diagnosis challenging. Hydatid disease and paragonimiasis involve the lung directly. Chronic schistosomiasis can lead to pulmonary hypertension. Strongyloides stercoralis infestation is capable of transforming into a fulminant fatal disease. In many types of nematode infestations, the pulmonary phase can cause acute eosinophilic pneumonia. Chest radiographs of patients with paragonimiasis and dirofilariasis can cause diagnostic confusion. Cases of tropical pulmonary eosinophilia typically present with refractory bronchial asthma. Most of these diseases are initially diagnosed by detecting eggs or larvae in stool, sputum, pleural fluid or tissue, and are confirmed by serologic testing. Cystic hydatid disease generally requires surgical treatment, whereas almost all other parasitic lung conditions can be treated medically. Summary Although most parasites that affect the lung are endemic to tropical and subtropical regions, immigration and travel practices have resulted in transfer of these diseases to other areas. It is important for physicians to know the epidemiologic characteristics, clinical presentations, and treatments of choice for these conditions.Öğe Extraskeletal ewings sarcoma presenting with multifocal intrathoracic mass lesions associated with mediastinal shift(Annals of thoracic surgery, 2006) Kuzucu, Akın; Erkal, Haldun Şükrü; Soysal, Ömer; Serin, MeltemExtraskeletal Ewing’s sarcoma is an uncommon disease that predominantly involves the soft tissues of the trunk or the extremities. This article presents a patient with multifocal intrathoracic mass lesions involving the mediastinum and the lingula associated with mediastinal shift, eventually diagnosed as extraskeletal Ewing’s sarcoma.Öğe Surgical management of upper and lower lobe bronchiectasis without middle lobe involvement Is middle lobectomy necessary(Journal of pediatric surgery, 2012) Ulutaş, Hakkı; Çelik, Muhammet Reha; Kuzucu, AkınPostoperative quality of life is a crucial factor in decisions regarding surgical management of bronchiectasis. The goal of surgical treatment in such cases is to eradicate diseased portions of lung while preserving as much healthy lung parenchyma as possible. The volume of remaining lung must be sufficient to fill the pleural space. In patients with bronchiectasis, it is extremely unusual to have upperand lower-lobe involvement without middle lobe involvement. A normal-sized middle lobe alone is usually not adequate to fill the right hemithorax. When the disease involves both the upper and lower lung lobes, surgeons must assess whether pneumonectomy is required. Herein, we describe the case of a patient with bronchiectasis who was successfully treated with upper and lower lobectomy and preservation of the middle lobe.Öğe False positive 18F FDG uptake in mediastinal lymph nodes detected with positron emission tomography in breast cancer a case report(Case Reports in Medicine, 2013) Uğurluer, Gamze; Kibar, Mustafa; Yavuz, Sinan; Kuzucu, Akın; Serin, MeltemBreast cancer is the most frequently diagnosed cancer among females. It is accepted that lymph node involvement with metastatic tumor and the presence of distant metastasis are the most important prognostic factors. Accurate staging is important in determining prognosis and appropriate treatment. Positron emission tomography with computed tomography detects malignancies using 2-[18F]-fluoro-2-deoxy-d-glucose (18F-FDG PET CT) with high accuracy and they contribute to decisions regarding diagnosis, staging, recurrence, and treatment response. Here, we report a case of false positive metastatic mediastinal lymph nodes that were diagnosed by 18F-FDG PET CT in a 40-year-old breast cancer patient who had undergone preoperative evaluation. Right paratracheal, prevascular, aorticopulmonary, precarinal, subcarinal, hilar, and subhilar multiple conglomerated mediastinal lymph nodes were revealed in addition to left breast mass and axillary lymph nodes. Mediastinoscopy was performed with biopsy and pathology was reported as granulomatous lymphadenitis. In conclusion, any abnormal FDG accumulation in unusual lymph nodes must be evaluated carefully and confirmed histopathologically.Öğe Primary idiopathic chylopericardium presenting with cardiac tamponade(Herz, 2014) Karakurt, Cemşit; Çelik, S. F.; Çelik, Muhammet Reha; Elkıran, .Özlem; Ulutaş, Hakkı; Kuzucu, AkınChylopericardium generally occurs after thoracic surgery or trauma. Primary idiopathic chylopericardium is an extremely rare condition especially in children and young adults. In recent years, a few case reports have been published on primary idiopathic chylopericardium due to lymphatic leak and fistula into the pericardium [1, 2, 3]. In this report, we described a 4-year-old boy with primary idiopathic chylopericardium presenting as cardiac tamponade.Öğe Hydatid cysts of the lung lesion size in relation to clinical presentation and therapeutic approach(Surg Today, 2014) Kuzucu, Akın; Ulutaş, Hakkı; Çelik, Muhammet Reha; Yekeler, ErdalPurposes The aim of this study was to assess the relationship between the pulmonary hydatid cyst size and the clinical presentation, surgical approach, and postoperative outcome. We review the problems encountered in treating large pulmonary hydatid cysts and highlight the risks associated with the rupture of the cyst and a delay of the surgical treatment. Methods The medical records of 169 patients surgically treated for lung hydatid cysts were reviewed. Patients were divided into two groups based on cyst size: group 1 (n = 128) with small (\10 cm) cysts and group 2 (n = 41) with giant (C10 cm) cysts. Data related to symptoms, preoperative complications, surgical procedures performed and postoperative morbidity were analyzed and compared. Results In both groups, the most common symptom was chest pain, followed by dyspnea and cough, respectively. There were no differences between the two groups with respect to cyst-associated parenchymal or pleural complications before surgery (p = 0.80). In the large majority of cases, the surgical treatment was cystotomy, removal of the cystic membrane and capitonnage. Wedge resection was performed in nine patients in total (seven in group 1, two in group 2) and one patient in group 2 required a lobectomy. Decortication was required significantly more frequently in group 2 than in group 1 (p = 0.001). Sixteen patients in group 1 and 10 patients in group 2 developed postoperative complications (p = 0.19). There was no peri or postoperative mortality. There was no difference between the groups with respect to the duration of hospitalization (p = 0.17). Two patients with complicated hydatid cysts in group 1 had recurrent lesions during follow-up, whereas there was no recurrence in group 2. Conclusion All pulmonary hydatid cysts should be surgically treated as soon as possible after their diagnosis in order to avoid complications. Most of these lesions, regardless of size, can be surgically managed with procedures that preserve the maximal lung parenchyma and yield excellent outcomes.Öğe Intrapleural fibrinolytic treatment management of 85 cases(Journal of Turgut Ozal Medical Center, 2015) Ulutaş, Hakkı; Çelik, Muhammet Reha; Kuzucu, AkınFibrous cortex developes over the lung in 7-10 days if the benign or malign pleural effusion consisting of blood, coagulum or empyema could not be drained. Thus, clinical conditions like trapped lung, restrictive lung disease, or dyspnea may appear as a result of fibrinous pleuritis. Both streptokinase and tissue plasminogen activator (tPA) are involved in the breakdown of proteins and fibrin. Hence, intrapleural fibrinolytic treatment (IPFT) may prevent invazive procedures by avoiding fibrous cortex develepment if it is applied at a proper time. Materials and Methods: Eighty five cases undergoing IPFT by tube or catheter thoracostomies between 2003-2013 are evaluated retrospectively. Patients have been evaluated according to age, symptoms, diagnosis, and response to treatment. Results: The mean age of the patients was 45.5 (65 males and 20 females). IPFT was performed in 30 patients with empyema, and in 20 and 13 patients due to postoperative or posttraumatic organised hematomas, respectively. Eleven patients underwent IPFT for loculated benign pleural effusions while 9 patients recieved the treatment for loculated malign pleural effusions. Complicated hydropneumothorax was the indication for IPFT in 2 patients. A total of sixty patients received tube thoracostomy while 25 patients underwent catheter thoracostomy. Tree patients had decortication and 4 underwent video assisted thoracoscopic (VATS) drainage due to failure of IPFT. Aseptic pleural space remained in 12 patients at the end of our study. One of the patients required blood transfusion and additional medical treatment for intrapleural hemorrhage secondary to the local absorption of the IPFT. Conclusion: IPFT is a safe, effective treatment which can be performed prior to much invasive surgical procedures in patients with loculated empyema, clotted hemothorax, or postoperative hematoma, and benign or malign pleural effusions which can not be drained due to high fibrinous contents.
