Tahir Sevval Eren
Istanbul Medeniyet University, Medical School, Faculty Member
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a vast number of infections and deaths that deeply affect the world. When the virus... more
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a vast number of infections and deaths that deeply affect the world. When the virus encounters the host cell, it binds to angiotensin-converting enzyme 2, then the S protein of the virus is broken down by the transmembrane protease serine 2 with the help of furin, allowing the virus to enter the cell. The elevated inflammatory cytokines suggest that a cytokine storm, also known as cytokine release syndrome, may play a major role in the pathology of COVID-19. Therefore, the aim of this study is to investigate the relationship between circulating furin levels, disease severity, and inflammation in patients with SARS-CoV-2. A total of 52 SARS-CoV-2 patients and 36 healthy control participants were included in this study. SARS- CoV-2 patients were scored by the disease activity score. Serum furin, presepsin, and interleukin-6 (IL-6) levels ...
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Background: Blood transfusion is a life-saving method in emergencies. However, it also carries the risk of pathogen transmission, which is called transfusion transmitted infections (TTIs). All donated blood samples were screened for... more
Background: Blood transfusion is a life-saving method in emergencies. However, it also carries the risk of pathogen transmission, which is called transfusion transmitted infections (TTIs). All donated blood samples were screened for hepatitis B surface antigen (HBsAg), anti-hepatitis C virus antibody (anti-HCV), anti-human immunodeficiency virus antigens (anti-HIV½) and syphilis using Venereal Disease Research Laboratory (VDRL) test. This study was designed and carried out to determine the seroprevalences of TTIs among blood donors with different ABO and Rh blood groups. Identification of a relation between different blood groups and TTIs was anticipated. Methods: All blood donors data obtained from the Blood Center of Marmara University Pendik Training and Research Hospital between January 2013 and October 2018 are analyzed retrospectively. Serum samples were examined for HBsAg, anti-HCV, anti-HIV½, and VDRL. Results: HBsAg and anti-HIV½ positivity positivity rates were not statist...
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The aim of this study was to present our experience in management of neonatal pneumothorax and factors contributing to persistent pneumothorax and mortality. Forty-two newborns were analyzed according to gestational age, birth weight,... more
The aim of this study was to present our experience in management of neonatal pneumothorax and factors contributing to persistent pneumothorax and mortality. Forty-two newborns were analyzed according to gestational age, birth weight, Apgar score, age of admittance, type of delivery, mother's age, side of pneumothorax, causes of pneumothorax, accompanying disorders, tube thoracostomy and mechanical ventilation durations, mean hospital stay, and deaths. Sixteen patients (38%) weighed less than 2500 g and 28 (66%) were preterm. The mean Apgar score at 5th minute was 6.2 (2-10). The pneumothorax was bilateral in 9 patients (21%). There was a defined underlying lung pathology in 26 (61%) patients and accompanying disorder in 14 (33%). Mean tube thoracostomy duration was 5 days (2-12). Twenty-five patients (59%) needed mechanical ventilation. Overall 10 babies died. Our findings indicated that underlying primary lung pathology, need for mechanical ventilation, and bilateral pneumotho...
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The study was performed on 11 female and 9 male dogs to investigate the effect of hypertonic NaCl in severe hypotension and shock caused by acute pulmonary artery obstruction. The investigation was performed in Dicle University Healt... more
The study was performed on 11 female and 9 male dogs to investigate the effect of hypertonic NaCl in severe hypotension and shock caused by acute pulmonary artery obstruction. The investigation was performed in Dicle University Healt Research Center (DUHRC). The youngest subject was six months old and the oldest was two years old. Their mean body weight was found as 19 kg. All the subjects were operated under general anesthesia. Invasive measurements of arterial pressure were performed through the right femoral artery by monitorization. All subjects were performed left thoracotomy, entrance to thorax was through 5th intercostal space, and first left then right pulmonary artery were circumferenced loosely with tape. After this, mean pulmonary artery pressures are recorded with the help of monitor by inserting canulla into the pulmonary artery. Pulmonary artery pressures at 3rd, 5th, 10th, 13th, 15th, 18th and 21st minutes after ligation of right main pulmonary artery and left lower l...
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We report a case of an hydatid cyst of diaphragma in a 34-year-old female who was admitted to our clinic for right basithoracic pain. Magnetic resonance imaging (MRI) reported a giant hydatid cyst including multiple vesicles at the right... more
We report a case of an hydatid cyst of diaphragma in a 34-year-old female who was admitted to our clinic for right basithoracic pain. Magnetic resonance imaging (MRI) reported a giant hydatid cyst including multiple vesicles at the right lower thoracic cavity. Surgical exploration revealed an independent giant diaphragmatic hydatid cyst. We performed cystotomy and more than 200 daughter vesicles were removed from the cyst. The rest of the giant cyst cavity was excised.
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Research Interests:
Bronchiectasis is described as destruction and the irreversible dilatation of bronchial structure. We wanted to demonstrate our surgical practice and outcome of surgical treatment in bronchiectasis. We studied records of 60 pediatric... more
Bronchiectasis is described as destruction and the irreversible dilatation of bronchial structure. We wanted to demonstrate our surgical practice and outcome of surgical treatment in bronchiectasis. We studied records of 60 pediatric patients who underwent surgical resection in our clinic between January 2000 and January 2013. The results were analyzed regarding factors influencing the outcome. There were 32 boys and 28 girls with a mean age of 9.45 years (range 2-15). The most common cause was childhood infection in 25 (41.66%). The mean duration of the symptoms was 42.93 months. Patients underwent 64 operations including 2 staged thoracotomies and 2 re-thoracotomies. Atelectasis was the most frequent complication. Longer duration of symptoms related to postoperative complication. The morbidity and mortality rates were 20% and 3.33%, respectively. The outcome was optimal in 92%. Forced expiratory volume in 1 s less than 60% of the predicted value, hemoptysis and duration of symptoms were found prognostic variables for postoperative morbidity with high ratios of odds coefficients by using Binary Logistic Regression Method. Complete and early resection of bronchiectasis provides a successful outcome. Duration of symptoms and timely intervention have a major impact on the management and prognosis.
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We report a rare case of lymphoepithelial cyst of the mediastinum. A 38-year-old woman was found to have a right paratracheal mediastinal mass on chest radiograph. Computed tomographic scanning showed a cystic mass on the right side of... more
We report a rare case of lymphoepithelial cyst of the mediastinum. A 38-year-old woman was found to have a right paratracheal mediastinal mass on chest radiograph. Computed tomographic scanning showed a cystic mass on the right side of the trachea. The encapsulated mass was situated in the upper mediastinum and was adherent to the trachea. The lesion was resected via a right thoracotomy. Histopathologic examination showed that the cystic mass was lined with 1 layer of ciliate columnar epithelium. There were no malignant foci. These findings were consistent with a diagnosis of multicystic lymphoepithelial cyst. The postoperative course was uneventful, and the patient was discharged from the hospital on the 7th postoperative day.
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Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study... more
Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study was to review the authors' surgical experience in tracheobronchial injuries. We reviewed our records of 29 patients with tracheobronchial injuries from January 1979 to December 2000. The median age was 22.7. Twenty-seven patients were male and two were females. The causes of traumas were penetrating injury in seventeen, blunt injury in eleven patients and animal bite in one. In sixteen patients cervical trachea, in nine main stem bronchus, in 3 lobar bronchus and in one patient mediastinal trachea were found to be injured. In seven of twenty-nine patients there were combined tracheal and esophageal injuries. Surgical approach was made by oblique incision, collar incisions and thoracotomy. In general we preferred primary repair. The overall morta...
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Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal... more
Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal lym-phoma presented with a sternal mass. Partial sternectomy with replacement by methyl methacrylate prosthesis was per-formed.
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Objective: Thoracic firearm injuries (TFI) have become increasingly prevalent in children. Our purpose is to assess the injury pattern, Injury Severity Score (ISS), length of hospital stay (LOS), management and outcome of children with... more
Objective: Thoracic firearm injuries (TFI) have become increasingly prevalent in children. Our purpose is to assess the injury pattern, Injury Severity Score (ISS), length of hospital stay (LOS), management and outcome of children with TFI with respect to the type of injury and to evaluate the value of ISS for predicting injury severity and the eventual need for thoracotomy, as well as the rate of morbidity and mortality. Methods: Between January 1987 and June 2002, 110 children (88 boys and 22 girls)#16 years of age with firearm injuries to the chest were evaluated. The children were divided in four groups according to cause of injury. An ISS was calculated for each child. Those children who died before admission were excluded from the study. The relationship between ISS and prognostic factors was analyzed in all four groups. Results: The mean age was 11.1 ^ 3.0 (range 3–16) years. Eighty-eight (80%) were male and 22 (20%) were female. The
A 39-year-old man was admitted with a stab wound to left lower neck. Chest X-ray revealed a left hydropneumothorax. Thoracentesis was performed and analysis of the fluid revealed chyle. Patient was treated conservatively by closed chest... more
A 39-year-old man was admitted with a stab wound to left lower neck. Chest X-ray revealed a left hydropneumothorax. Thoracentesis was performed and analysis of the fluid revealed chyle. Patient was treated conservatively by closed chest drainage and total parenteral nutrition. On the basis of this clinical report and review of the literature, it is concluded that thoracic duct injury should be kept in mind in penetrating neck trauma and conservative treatment should be the first line therapy.
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Bronchiectasis is pathologically defined as a condition in which there are abnormal and permanent dilatations of proximal bronchi with predominance at the level of the second to the sixth bronchial division. This definition differentiates... more
Bronchiectasis is pathologically defined as a condition in which there are abnormal and permanent dilatations of proximal bronchi with predominance at the level of the second to the sixth bronchial division. This definition differentiates true bronchiectasis from functional bronchiectasis or pseudobronchiectasis, which is expected to return to normal once control of infection has been achieved (Deslauriers et al., 1998). Bronchiectasis was first described by Laenec in 1819 and, before the antibiotic era, was considered a morbid disease with a high mortality rate from respiratory failure and cor pulmonale (Balkanli et al., 2003). With the development of antibiotics in the 1940s, this entity began to be seen less frequently, but, with the emergence of drug-resistant microorganisms and the increasing frequency of drugresistant tuberculosis, an increased incidence of postinfectious bronchiectasis is being noted (Miller, 2000). The current increase in tuberculosis rates is directly relat...
The purpose of this retrospective study was to analyze our experience with mediastinal cysts, emphasizing the clinical presentations and results of surgery.Thirty-two patients with mediastinal cysts underwent surgery from January 2000... more
The purpose of this retrospective study was to analyze our experience with mediastinal cysts, emphasizing the clinical presentations and results of surgery.Thirty-two patients with mediastinal cysts underwent surgery from January 2000 through June 2005. The records of these patients were reviewed for age at presentation, sex, signs and symptoms at presentation, results of the imaging techniques, types of mediastinal cysts, location and size of cysts, types of surgical procedure, length of hospital stay, early postoperative complications, death, and other follow-up information.The 32 mediastinal cysts comprised 12 bronchogenic, 9 pericardial, 7 thymic, and 2 enteric cysts, together with 2 cystic teratomas. Overall, 14 of the 32 patients with mediastinal cysts were asymptomatic. The surgical approach was thoracotomy in 30 patients and median sternotomy in 2 patients. The mean length of hospital stay was 7.7 ± 2.6 days. All patients were free from recurrence during the mean follow-up p...
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The aim of this study was to present our experience in management of neonatal pneumothorax and factors contributing to persistent pneumothorax and mortality. Forty-two newborns were analyzed according to gestational age, birth weight,... more
The aim of this study was to present our experience in management of neonatal pneumothorax and factors contributing to persistent pneumothorax and mortality. Forty-two newborns were analyzed according to gestational age, birth weight, Apgar score, age of admittance, type of delivery, mother's age, side of pneumothorax, causes of pneumothorax, accompanying disorders, tube thoracostomy and mechanical ventilation durations, mean hospital stay, and deaths. Sixteen patients (38%) weighed less than 2500 g and 28 (66%) were preterm. The mean Apgar score at 5th minute was 6.2 (2-10). The pneumothorax was bilateral in 9 patients (21%). There was a defined underlying lung pathology in 26 (61%) patients and accompanying disorder in 14 (33%). Mean tube thoracostomy duration was 5 days (2-12). Twenty-five patients (59%) needed mechanical ventilation. Overall 10 babies died. Our findings indicated that underlying primary lung pathology, need for mechanical ventilation, and bilateral pneumotho...
Research Interests:
Research Interests:
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As the COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to spread around the globe, effective vaccination protocols are under deployment. Alternatively, the use of convalescent plasma (CP)... more
As the COVID-19 pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to spread around the globe, effective vaccination protocols are under deployment. Alternatively, the use of convalescent plasma (CP) therapy relies on the transfer of the immunoglobulin repertoire of a donor that has recovered from the disease as a means of passive vaccination. While the lack of an effective antiviral treatment inadvertently increases the interest in CP products, initial clinical evaluation on COVID-19 patients revealed that critical factors determining the outcome of CP therapy need to be defined clearly if clinical efficacy is to be expected. Measurement of neutralizing activity against SARS-CoV-2 using wildtype virus presents a reliable functional assay but the availability of suitable BSL3 facilities for virus culture restricts its applicability. Instead, the use of pseudovirus particles containing elements from the SARS-CoV-2 virus is widely applied to dete...
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Aims: We aimed to evaluate the results of surgical treatment of huge hydatid cysts diagnosed at our clinic. Ruptured cysts have caused severe complications. Perforation of very large cysts is always possible. These can result in fatal... more
Aims: We aimed to evaluate the results of surgical treatment of huge hydatid cysts diagnosed at our clinic. Ruptured cysts have caused severe complications. Perforation of very large cysts is always possible. These can result in fatal complications. We present our surgical experience with large hydatid cysts in this paper. Materials and Methods : We retrospectively reviewed 191 patients diagnosed as hydatid cysts who were treated surgically. Among these, 67 cases were studied with a dimension of 10 cm or more. Age, gender, symptom, ruptured or intact, dimension, quantity and radiologic findings of the cases were determined. Incipiency of complaint, postoperative morbidity and length of hospital stay for all cases were assessed. Results: The cases comprised 41 females and 26 males. The mean age was 20.20 ± 16.13 (5-52) years. Hospital stay for the huge and ruptured cysts group was 11.21 ± 4.04 days. The huge but unruptured cysts group had a hospital stay of 8.40 ± 2.48 days. All patients underwent thoracotomy. Cystotomy plus capitonnage in 52 (77.61%), decortication in addition to cystotomy plus capitonage in seven (10.6%), cystotomy in six (8.6%), cystotomy plus enucleation in one and primer closure in one were carried out. Postoperative mortality was absent; however, 17 cases were complicated; atelectasis was found in five cases, prolonged air leakage in five cases, apical aseptic pleural space in three cases, empyema in two cases, hemopthisis in one case and diaphragmatic elevation in one. Conclusions: Immediate surgery is of choice in giant cysts. Possibility of complication and longer stay in the ruptured group is higher compared with simple cystic disease.
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Research Interests:
Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal... more
Any mass on the chest wall may not always be the primary local pathology. A case of lymphoma with an aggressive course may involve the sternum through local invasion and can mimic a chest wall tumour. A 15-year-old boy with mediastinal lymphoma presented with a sternal mass. Partial sternectomy with replacement by methyl methacrylate prosthesis was performed.
The study was performed on 11 female and 9 male dogs to investigate the effect of hypertonic NaCl in severe hypotension and shock caused by acute pulmonary artery obstruction. The investigation was performed in Dicle University Healt... more
The study was performed on 11 female and 9 male dogs to investigate the effect of hypertonic NaCl in severe hypotension and shock caused by acute pulmonary artery obstruction. The investigation was performed in Dicle University Healt Research Center (DUHRC). The youngest subject was six months old and the oldest was two years old. Their mean body weight was found as 19 kg. All the subjects were operated under general anesthesia. Invasive measurements of arterial pressure were performed through the right femoral artery by monitorization. All subjects were performed left thoracotomy, entrance to thorax was through 5th intercostal space, and first left then right pulmonary artery were circumferenced loosely with tape. After this, mean pulmonary artery pressures are recorded with the help of monitor by inserting canulla into the pulmonary artery. Pulmonary artery pressures at 3rd, 5th, 10th, 13th, 15th, 18th and 21st minutes after ligation of right main pulmonary artery and left lower l...
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To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one... more
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one (48.8%) underwent pleural tenting in addition to bulla excision (experimental group, EG). Twenty-two (51.2%) underwent bulla excision plus pleural abrasion (11 patients), apical partial pleurectomy (9 patients) and complete apical pleurectomy (2 patients) (control group, CG). The most frequent symptom was chest pain (37.2%). Surgical indications were recurrence in 21 (48.8%), prolonged air leak in 12 (27.9%), failure of expansion without air leak in 6 (13.9%), high risk occupancy in 2 (4.6%) and empyema due to air leak in 2 (4.6%). Air leak time was decreased by tenting (1.9 days vs 3.7 days) as well as time of drainage (4.8 vs 6.9) and hospital stay (5.8 vs 7.9). Morbidity was 9.5% in EG and 9.1% in CG. Causes of morbidity were postoperative hematoma...
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Twenty-nine cases, penetrating wounds to the heart, who were operated in the thoracic and cardiovascular surgery department of our University during January 1995-August 2000 were reevaluated. Twenty nine patients were men and the mean age... more
Twenty-nine cases, penetrating wounds to the heart, who were operated in the thoracic and cardiovascular surgery department of our University during January 1995-August 2000 were reevaluated. Twenty nine patients were men and the mean age was 22.6 (min 12, max 45). The cause of injury was stab wounds in 28 cases and gunshot wounds in 1 case. Besides the clinical findings; teleradiography, echocardiography were valuable for the diagnosis. Surgery was applied in emergent conditions for all cases. Interventions were performed 28 anterolateral thoracotomy, 1 bilaterally anterolateral thoracotomy and additionally 4 laparatomy were performed. The most frequent side of injury was right ventricule. Our mortality ratio was 17.2%, morbidity ratio 17.2%. We think that fast transportation, urgent diagnostic study and immediate surgical intervention important parameters which decrease of the mortality.
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Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study... more
Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study was to review the authors' surgical experience in tracheobronchial injuries. We reviewed our records of 29 patients with tracheobronchial injuries from January 1979 to December 2000. The median age was 22.7. Twenty-seven patients were male and two were females. The causes of traumas were penetrating injury in seventeen, blunt injury in eleven patients and animal bite in one. In sixteen patients cervical trachea, in nine main stem bronchus, in 3 lobar bronchus and in one patient mediastinal trachea were found to be injured. In seven of twenty-nine patients there were combined tracheal and esophageal injuries. Surgical approach was made by oblique incision, collar incisions and thoracotomy. In general we preferred primary repair. The overall morta...
Research Interests:
Objective: Thoracic firearm injuries (TFI) have become increasingly prevalent in children. Our purpose is to assess the injury pattern, Injury Severity Score (ISS), length of hospital stay (LOS), management and outcome of children with... more
Objective: Thoracic firearm injuries (TFI) have become increasingly prevalent in children. Our purpose is to assess the injury pattern, Injury Severity Score (ISS), length of hospital stay (LOS), management and outcome of children with TFI with respect to the type of injury and to evaluate the value of ISS for predicting injury severity and the eventual need for thoracotomy, as
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Esophageal foreign bodies (FBs) in children are a commonly seen complaint that can cause severe morbidity. Different methods are used for their extraction. We reviewed our cases and described direct extraction technique. The... more
Esophageal foreign bodies (FBs) in children are a commonly seen complaint that can cause severe morbidity. Different methods are used for their extraction. We reviewed our cases and described direct extraction technique. The specifications of 1116 children with esophageal FBs between 1990 and 2000 were evaluated. All FB cases were considered emergencies and intervention was performed in the operating theater.
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Foreign body (FB) inhalation into airways of the respiratory system is a life-threatening condition and can be fatal. The purpose of this survey was to evaluate the types and characteristics of inhaled foreign bodies, the age distribution... more
Foreign body (FB) inhalation into airways of the respiratory system is a life-threatening condition and can be fatal. The purpose of this survey was to evaluate the types and characteristics of inhaled foreign bodies, the age distribution of children, and the outcome. We outlined a retrospective review of hospital data of patients between 1990 and 2012. FB inhalation occurring in children 0 year to 16 years was considered for inclusion. During the study period, 1,660 patients undergoing bronchoscopy with the diagnosis of FB were included. Deaths on arrival were excluded. Of the patients, 53% were male, and 47% were female (p > 0.05). The mean age was 6.2 years for girls and 4.7 years for boys. In 57% of all cases, the children were younger than 3 years. An FB was found within the respiratory tract of 1,565 patients. The FBs were always extracted by using rigid bronchoscopy. Hospitalization was always required owing to an institutional requirement. The origin of the FBs were within the two main groups of food and objects. Food FBs included seeds, nuts, beans, and fruit parts. FB objects included pins, toy parts, and metal pieces. FB and subsequent treatment revealed that morbidity was present; however, mortality was rare. Most of the inhaled FBs were found in the bronchial tree. Children younger than 3 years are more vulnerable. There seemed to be an association between the aspirated FBs and season, geographic locality, and sociocultural environment. The removal of choice is rigid bronchoscopy under general anesthesia. That most cases of FB in children occurs under the supervision of adults indicates that the incidence and severity of airway FB inhalation can be reduced by parental education and public awareness. Epidemiologic study, level III.
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Research Interests:
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one... more
To assess the efficacy of pleural tenting in patients with complicated primary spontaneous pneumothorax (PSP). From 1988 through 2001, 43 patients underwent operations. Mean age was 30.4 years; the male/female ratio was 9.7. Twenty-one (48.8%) underwent pleural tenting in addition to bulla excision (experimental group, EG). Twenty-two (51.2%) underwent bulla excision plus pleural abrasion (11 patients), apical partial pleurectomy (9 patients) and complete apical pleurectomy (2 patients) (control group, CG). The most frequent symptom was chest pain (37.2%). Surgical indications were recurrence in 21 (48.8%), prolonged air leak in 12 (27.9%), failure of expansion without air leak in 6 (13.9%), high risk occupancy in 2 (4.6%) and empyema due to air leak in 2 (4.6%). Air leak time was decreased by tenting (1.9 days vs 3.7 days) as well as time of drainage (4.8 vs 6.9) and hospital stay (5.8 vs 7.9). Morbidity was 9.5% in EG and 9.1% in CG. Causes of morbidity were postoperative hematoma, prolonged air leak, expansion failure and blunt posterior sinus one of each. Re-operation needed for postoperative hematoma in CG. Mean follow-up was 5.1 years and 1 (4.5%) recurrence observed in CG. Tenting of the dependent lung from the apical pleura after bullectomy via axillary thoracotomy lessens air leak time without recurrence and low morbidity.
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The study was performed on 11 female and 9 male dogs to investigate the effect of hypertonic NaCl in severe hypotension and shock caused by acute pulmonary artery obstruction. The investigation was performed in Dicle University Healt... more
The study was performed on 11 female and 9 male dogs to investigate the effect of hypertonic NaCl in severe hypotension and shock caused by acute pulmonary artery obstruction. The investigation was performed in Dicle University Healt Research Center (DUHRC). The youngest subject was six months old and the oldest was two years old. Their mean body weight was found as 19 kg. All the subjects were operated under general anesthesia. Invasive measurements of arterial pressure were performed through the right femoral artery by monitorization. All subjects were performed left thoracotomy, entrance to thorax was through 5th intercostal space, and first left then right pulmonary artery were circumferenced loosely with tape. After this, mean pulmonary artery pressures are recorded with the help of monitor by inserting canulla into the pulmonary artery. Pulmonary artery pressures at 3rd, 5th, 10th, 13th, 15th, 18th and 21st minutes after ligation of right main pulmonary artery and left lower lobe pulmonary artery, and mean artery pressures are recorded. Sodium nitroprusside is given to half of the subjects and nitroglycerine is given to the other half in order to lower pulmonary hypertension. Pulmonary arterial pressure measurements following administration of these drugs are recorded. 7.5% of NaCl infusion to subjects is performed in case of hypotension and shock. Isotonic NaCl solution is used in the control group. Mean arterial pressures in group receiving sodium nitroprusside + 7.5% NaCl solution are found significantly higher statistically when compared to group receiving sodium nitroprusside + 0.9% NaCl isotonic solution. Difference in mean arterial pressures were not found statistically significant in the group receiving nitroglycerin + 7.5% NaCl when compared to group receiving nitroglycerin + 0.9% NaCl solution.
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Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study... more
Tracheobronchial injuries are among the least common sort of thoracic traumas. This injury can be life threatening. However, successful diagnosis and treatment can prevent devastating acute or delayed complications. The aim of this study was to review the authors' surgical experience in tracheobronchial injuries. We reviewed our records of 29 patients with tracheobronchial injuries from January 1979 to December 2000. The median age was 22.7. Twenty-seven patients were male and two were females. The causes of traumas were penetrating injury in seventeen, blunt injury in eleven patients and animal bite in one. In sixteen patients cervical trachea, in nine main stem bronchus, in 3 lobar bronchus and in one patient mediastinal trachea were found to be injured. In seven of twenty-nine patients there were combined tracheal and esophageal injuries. Surgical approach was made by oblique incision, collar incisions and thoracotomy. In general we preferred primary repair. The overall mortality rate was 24%. In our opinion, the number of complications and mortality can be diminished by early recognition of the injuries and treatment.
Research Interests:
Twenty-nine cases, penetrating wounds to the heart, who were operated in the thoracic and cardiovascular surgery department of our University during January 1995-August 2000 were reevaluated. Twenty nine patients were men and the mean age... more
Twenty-nine cases, penetrating wounds to the heart, who were operated in the thoracic and cardiovascular surgery department of our University during January 1995-August 2000 were reevaluated. Twenty nine patients were men and the mean age was 22.6 (min 12, max 45). The cause of injury was stab wounds in 28 cases and gunshot wounds in 1 case. Besides the clinical findings; teleradiography, echocardiography were valuable for the diagnosis. Surgery was applied in emergent conditions for all cases. Interventions were performed 28 anterolateral thoracotomy, 1 bilaterally anterolateral thoracotomy and additionally 4 laparatomy were performed. The most frequent side of injury was right ventricule. Our mortality ratio was 17.2%, morbidity ratio 17.2%. We think that fast transportation, urgent diagnostic study and immediate surgical intervention important parameters which decrease of the mortality.
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The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum. 27 children aged 6-15-years were included in the study. Pulmonary function tests and chest... more
The indications for repair of pectus excavatum are controversial. We present our surgical results in children with severe pectus excavatum. 27 children aged 6-15-years were included in the study. Pulmonary function tests and chest measurements were performed pre- and postoperatively. Deformed cartilages were resected subperichondrially, and a Kirchner wire was used to support the chest cage; it was removed 5 days after the operation. Fourteen children with restricted pulmonary function were considered to have excessive pectus excavatum. 3 patients had asthma-like symptoms that resolved postoperatively. None suffered chest pain postoperatively. Postoperative hospital stay was 7.1 days. Only minor complications occurred postoperatively. The mean pectus severity index was 0.27 ± 0.2 preoperatively and 0.41 ± 0.1 postoperatively (p < 0.05). For children with restricted pulmonary function, it was 0.17 ± 0.3 preoperatively and 0.38 ± 0.2 postoperatively (p < 0.05). Mean percentage of predicted forced expiratory volume in 1 s changed significantly from 79.2% ± 17.8% preoperatively to 83.6% ± 12.2% by the 3rd postoperative month. For children with a pectus severity index <0.2, it changed from 68.5% ± 13.2% preoperatively to 82.3% ± 13.4%. Pulmonary restriction correlated with a worse pectus severity index (r = 0.8). After 6 and 13 months, a minor decrease in pulmonary function was noted. Significant increases in right and left ventricular function occurred in cases of severe deformity. Surgery is recommended not only for cosmetic reasons but also to increase cardiorespiratory functional capacity and alleviate symptoms. Kirchner wires can be used safely.
Research Interests: Treatment Outcome, Adolescent, Humans, Child, Female, and 15 moreMale, Lung, Length of Stay, Time Factors, Age Factors, Equipment Design, Orthopedic Procedures, Bone Wires, Postoperative Complications, Severity of Illness Index, Recovery of Function, Reoperation, Respiratory function tests, Cardiovascular medicine and haematology, and Device Removal
The strategy for treatment of flail chest remains controversial. Various alternatives were assessed by reviewing the records of 64 patients treated from 1991 through 2000. Patients were classified according to therapeutic approach: group... more
The strategy for treatment of flail chest remains controversial. Various alternatives were assessed by reviewing the records of 64 patients treated from 1991 through 2000. Patients were classified according to therapeutic approach: group 1 was 27 patients who underwent open fixation of the fractured ribs, group 2 was 19 patients managed by intermittent positive-pressure ventilation, and group 3 was 18 patients managed mainly by synchronized intermittent mandatory ventilation. Two patients initially treated by ventilation underwent successful open fixation. In group 1, ventilatory support was required in 21 (77.8%) patients postoperatively, the mean duration of ventilation was 3.1 days, mean hospital stay was 18.3 days, morbidity was 11.1% (3/27), and mortality was 11.1%. In groups 2 and 3, the mean time for stabilization of paradoxical chest wall movement was 6.6 days, and mean duration of ventilation was 7.2 days. Mortality was 27.0% (10/37) in patients treated nonsurgically; 21.0%...
Research Interests: Treatment Outcome, Risk assessment, Probability, Humans, Female, and 13 moreMale, Follow-up studies, Fracture Healing, Adult, Analysis of Variance, Retrospective Studies, Risk Assessment, Predictive value of tests, Case Control Studies, Severity of Illness Index, Thoracotomy, Flail chest, and Cardiovascular medicine and haematology
Capitonnage is usually advocated for obliteration of the residual cavity after removal of a hydatid cyst. To assess a non-capitonnage method, results in 33 patients were compared with those of 80 patients who had capitonnage. The... more
Capitonnage is usually advocated for obliteration of the residual cavity after removal of a hydatid cyst. To assess a non-capitonnage method, results in 33 patients were compared with those of 80 patients who had capitonnage. The non-capitonnage patients had a shorter mean hospital stay and earlier radiologic improvement but higher morbidity than the capitonnage patients. Extended air leak caused significant morbidity in each group. Bronchoscopic intervention was needed for atelectasis in 1 patient. There was no mortality in either group. In the follow-up period, no late complication or recurrence was observed in non-capitonnage patients. Among the capitonnage patients, 2 had bronchiectasis, and suture material expectoration occurred in one. The non-capitonnage method may be a good alternative to the capitonnage procedure for lung hydatid cyst. Better management of bronchial openings should improve the results of the non-capitonnage method.
Research Interests:
Capitonnage is usually advocated for obliteration of the residual cavity after removal of a hydatid cyst. To assess a non-capitonnage method, results in 33 patients were compared with those of 80 patients who had capitonnage. The... more
Capitonnage is usually advocated for obliteration of the residual cavity after removal of a hydatid cyst. To assess a non-capitonnage method, results in 33 patients were compared with those of 80 patients who had capitonnage. The non-capitonnage patients had a shorter mean hospital stay and earlier radiologic improvement but higher morbidity than the capitonnage patients. Extended air leak caused significant morbidity in each group. Bronchoscopic intervention was needed for atelectasis in 1 patient. There was no mortality in either group. In the follow-up period, no late complication or recurrence was observed in non-capitonnage patients. Among the capitonnage patients, 2 had bronchiectasis, and suture material expectoration occurred in one. The non-capitonnage method may be a good alternative to the capitonnage procedure for lung hydatid cyst. Better management of bronchial openings should improve the results of the non-capitonnage method.
Research Interests:
The strategy for treatment of flail chest remains controversial. Various alternatives were assessed by reviewing the records of 64 patients treated from 1991 through 2000. Patients were classified according to therapeutic approach: group... more
The strategy for treatment of flail chest remains controversial. Various alternatives were assessed by reviewing the records of 64 patients treated from 1991 through 2000. Patients were classified according to therapeutic approach: group 1 was 27 patients who underwent open fixation ...
Research Interests: Treatment Outcome, Risk assessment, Probability, Humans, Female, and 13 moreMale, Follow-up studies, Fracture Healing, Adult, Analysis of Variance, Retrospective Studies, Risk Assessment, Predictive value of tests, Case Control Studies, Severity of Illness Index, Thoracotomy, Flail chest, and Cardiovascular medicine and haematology
ABSTRACT Background: Empyema is a well-known sequelae of pneumonia, which is increasingly being reported in children despite strict management. The appropriate management remains controversial. The aim of this study was to evaluate... more
ABSTRACT Background: Empyema is a well-known sequelae of pneumonia, which is increasingly being reported in children despite strict management. The appropriate management remains controversial. The aim of this study was to evaluate different management options of postpneumonic empyema in children. Materials and methods: A total of 330 patients were reviewed between 2002 and 2012; their ages ranged from 1.25 to 15 years, with a median age of 4.3 years. The various management procedures included thoracentesis (n=11), chest tube drainage (n=229), chest tube drainage with intrapleural fibrinolytic therapy (n=117), video-assisted thoracoscopic surgery (VATS) (n=35), and thoracotomy because of a trapped lung noted on admissions and failed procedures (n=94). Results: Variable success rates were noted as follows: tube thoracotomy (48.24%), fibrinolytic treatment (68.37%), and VATS (85.71%). Postoperative complications (11.14%) included wound infection (n=10), atelectasis (n=18), delayed expansion (n=7), and need for reoperation (n=2). Four patients died (1.21%), two of them following thoracotomy, one patient after fibrinolysis, and one patient following VATS. Patients treated with thoracotomy recovered completely. Conclusion: New therapeutic modalities had variable success rates in children with postpneumonic empyema. Thoracotomy is still needed as a last resort for cases unresponsive to chemical fibrinolysis and following failed thoracoscopy.
Cystic hygroma is a benign tumor of lymphatic tissue. It usually develops before the second year of life and is rarely seen in adults. A 26-year-old woman was referred to our clinic with a swelling in the left supraclavicular region,... more
Cystic hygroma is a benign tumor of lymphatic tissue. It usually develops before the second year of life and is rarely seen in adults. A 26-year-old woman was referred to our clinic with a swelling in the left supraclavicular region, which had appeared 5 months earlier and grown rapidly. Ultrasonography, computed tomography, and magnetic resonance imaging showed a 7-cm cystic lesion in the neighborhood of the carotid artery and jugular vein medially and the supraclavicular region inferiorly The lesion was dissected completely from the surrounding tissue. The patient had no complications and was discharged on postoperative day one.