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Öğe Bilaterally recurrent spontaneous pneumothorax due to lymphangioleiomyomatosis(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Karapolat, Sami; Erbaş, Mesut; Dumlu, Talha; Erdem, Havva; Karapolat, Banu; Erekul, SelimPulmonary lymphangioleiomyomatosis is an extremely rare interstitial lung disease. The clinical presentation is generally recurrent spontaneous pneumothorax and progressive dyspnea. No definitive treatment option is available and it leads to respiratory failure due to multicystic destruction of the lung parenchyma in the following years. A 39-year-old female patient was admitted to our clinic with the complaints of sudden onset dyspnea and diffuse chest pain. Auscultation revealed decreased respiratory sounds in both lungs. Chest X-ray showed bilateral pneumothorax and bilaterally tube thoracostomy was performed. Thoracic tomography demonstrated a few thin-wall cystic structures in both lungs with a higher number on the right side. We performed bullectomy, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through right posterolateral thoracotomy. One month later, we performed bullectomy, bulla ligation, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through left posterolateral thoracotomy due to the left recurrent pneumothorax. The patient was diagnosed with lymphangioleiomyomatosis based on the histopathological examination. No recurrent pneumothorax was observed at the end of the two-year follow-up period. Lymphangioleiomyomatosis should be kept in mind in premenopausal women who have bilaterally recurrent spontaneous pneumothorax. Early surgical treatment should be planned in these patients due to multiple pneumothorax recurrences with conservative procedures.Öğe Deneysel akut pankreatit modelinde erdosteinin etkileri(Düzce Üniversitesi, 2012) Karapolat, Banu; Yaşar, MehmetÖZETAkut pankreatit kendi kendini sınırlayan hafif semptomlardan multiorgan yetmezliği ile seyreden fulminant gidişe kadar oldukça geniş klinik sunum gösterebilen bir hastalıktır.Bu çalışmada 30 adet erkek Wistar albino rat her birinde 10 adet olacak şekilde 3 gruba ayrılmıştır. Grup 1'de herhangi bir işlem yapılmamıştır. Grup 2 ve Grup 3' teki ratlara birer saat ara ile 6 kez toplam 80 ?g/kg olacak şekilde subkutan cerulein enjekte edilerek deneysel pankreatit modeli oluşturulmuş ve bu durumun teyidi için kan amilaz ve lipaz değerlerine bakılmıştır. Grup 3'teki ratlara 10 mg/kg Erdostein orogastrik yol ile verilmiştir. Bu tedaviye 2 gün daha devam edilmiş ve ratlar 3. gün sakrifiye edilmiştir. Ratlardan çıkarılan pankreas dokusunda ödem, inflamasyon, yağ nekrozu, asiner nekroz ve vakuolizasyon histopatolojik olarak araştırılmış ve 0 ile 4 arasında skorlar verilerek değerlendirme yapılmıştır.Cerulein kullanımıyla amilaz ve lipaz gibi biyokimyasal tetkiklerin sonuçları ve pankreas dokularının histopatolojik olarak incelenmesi sonucunda ratlarda akut pankreatit gelişmiş ve pankreas dokusunda ciddi boyutlarda ödem, inflamasyon, asiner nekroz, yağ nekrozu ve vakuolizasyon gözlenmiştir. Grup 3'teki ratlarda Erdosteinin beklenilen antiinflamatuar etkisi elde edilmiş ve oluşan pankreatit şiddetinin azaldığı histopatolojik olarak gösterilmiştir. Çalışmanın istatistiksel sonuçları incelendiğinde ise Erdosteinin akut pankreatit dokusunda inflamasyon, asiner nekroz, yağ nekrozu ve vakuolizasyon skorlarında anlamlı azalmalara yol açtığı ortaya çıkmıştır.Sonuç olarak Cerulein ile ratlarda ağır pankreatit oluşturulmuş ve Erdostein kullanımı ile pankreatit şiddeti azalmış olarak bulunmuştur. Erdostein ile elde ettiğimiz bu olumlu sonuçlar daha kapsamlı deneysel ve klinik çalışmalar ile desteklenebildiği takdirde Erdostein akut pankreatit tedavisinde olumlu etkileri olan yeni bir tedavi yöntemi olarak kullanılabilecektir.Öğe Effects of Erdosteine on Experimental Acute Pancreatitis Model(Coll Physicians & Surgeons Pakistan, 2017) Karapolat, Banu; Karapolat, Sami; Gürleyik, Emin; Yaşar, MehmetObjective: To create acute pancreatitis condition experimentally in rats using cerulein, and to reveal histopathological effects in pancreatic tissue with erdosteine. Study Design: An experimental study. Place and Duration of Study: Department of General Surgery, Duzce University, Turkey, from June to October 2014. Methodology: Thirty male Wistar albino rats were divided into three groups. No procedures were applied to Group 1. The rats in Group 2 and Group 3 were injected cerulein, to establish an experimental pancreatitis model and the blood amylase and lipase values were examined. The rats in Group 3 were given 10 mg/kg erdosteine. This treatment was continued for another 2 days and the rats were sacrificed. The pancreatic tissues were examined histopathologically for edema, inflammation, acinar necrosis, fat necrosis, and vacuolization. Results: The lipase and amylase values and the histopathological examination of pancreatic tissues evidenced that the experimental acute pancreatitis model was established and edema, inflammation, acinar necrosis, fat necrosis, and vacuolization were observed in the pancreatic tissues. The statistical results suggest that erdosteine can decrease the edema, inflammation, acinar necrosis, fat necrosis and vacuolization scores in the tissues. Conclusion: The severity of acute pancreatitis, induced by cerulein in rats, is reduced with the use of erdosteine.Öğe The Effects of Erdosteine on Tracheal Healing in Rats(Wroclaw Medical Univ, 2011) Karapolat, Sami; Gezer, Suat; Yıldırım, Ümran; Dumlu, Talha; Karapolat, Banu; Özaydın, İsmet; Kandiş, HayatiBackground. Proliferating scar tissue and strictures, which are still serious problems of tracheal surgery, are caused by an inflammatory reaction with subsequent edema and granulation tissue. Tracheal stenosis leads to severe morbidity and multiple surgical operations are sometimes needed in those patients. Objectives. To assess the effect of the antioxidant and anti-inflammatory drug Erdosteine to prevent tracheal stenosis in a rat model. Material and Methods. Fourteen female adult Wistar albino rats were divided into two groups, a control group (Group A, n = 7) and an Erdosteine group (Group B, n = 7). Under general anesthesia, the tracheas were incised vertically, extending from the 3(rd) to the 5(th) cartilaginous rings and closed primarily with absorbable sutures. Group A had 0.5 cc/day 0.9% NaCl, and Group B had 10 mg/kg/day Erdosteine, both administered by gavages and maintained for 10 days. At the end of the procedure, the rats were sacrificed and their tracheas were excised from cricoid cartilage to carina. The specimens were histologically evaluated using light microscopy and scored for inflammatory cell infiltration, angiogenesis, fibroblast proliferation, collagen deposition, and epithelial regeneration. All of the results were statistically analyzed and a value of p < 0.05 was considered statistically significant. Results. There were only meaningful differences in epithelial regeneration (p = 0.001), displaying that epithelial regeneration was better in Group B. However, the differences in inflammatory cell infiltration, angiogenesis, fibroblast proliferation and collagen deposition did not reach statistical significance. Conclusions. The severity of pathological changes forming in the tissue after tracheal surgery could not be reduced with Erdosteine use. Thus, Erdosteine does not seem to be an applicable preventive treatment agent for possible postsurgical tracheal stenosis (Adv Clin Exp Med 2011, 20, 1, 31-37).Öğe The histopathological evaluation of mediastinal lymph node stations in sarcoidosis(Drunpp-Sarajevo, 2012) Karapolat, Sami; Yıldırım, Ümran; Karapolat, Banu; Erbaş, MesutBackground: Even if the clinical and radiological findings indicate sarcoidosis, diagnosis can be established by showing histopathologically the sarcoid granulomas in the tissue. Mediastinoscopy is a surgical procedure that is commonly used to obtain histological specimens to examine for mediastinal lymph node involvement in sarcoidosis. Objective: To demonstrate which of the mediastinal lymph node stations that the biopsies were taken had the highest diagnostic value for histopathological examination in sarcoidosis. Methods: Operative and histopathology reports of 14 patients who underwent mediastinoscopy and diagnosed with sarcoidosis in the Thoracic Surgery Clinic of Duzce University School of Medicine, between January 2009 and January 2011 were reviewed retrospectively. Results: On thorax tomography images of the patients with sarcoidosis, lymph nodes of the bilateral lower paratracheal and hilar mediastinal lymph node stations were frequently enlarged to pathological dimensions. In the majority of the cases, biopsies were taken by mediastinoscopy from the bilateral lower paratracheal lymph node stations. Histopathological examination of the biopsy material showed severe noncaseating granulomatous inflammation, most commonly in the right lower paratracheal, followed by left lower paratracheal and at least common highest mediastinal lymph node stations. Conclusions: During mediastinoscopy to be performed on patients with suspected sarcoidosis, we recommend that priority be given to taking biopsies from the lower paratracheal lymph nodes and sent for frozen examination for definitive diagnosis to prevent unnecessary mediastinal dissection that might result in serious complications.Öğe Incidental Papillary Thyroid Microcarcinoma in an Endemic Goiter Area(Hindawi Ltd, 2016) Gürleyik, Emin; Gürleyik, Günay; Karapolat, Banu; Önsal, UfukClinical and pathological characteristics of incidental papillary thyroid microcancer cases, surgical, medical, and nuclear treatment methods, and patients' outcome were studied during follow-up period of 102 months. We studied 37 patients with incidental papillary thyroid microcancer (I-PTM). The surgical procedure was total thyroidectomy in 29 and hemithyroidectomy in 8 patients. Size, multifocality, and bilateralism of PTMfoci, thyroid capsule invasion, and presence of lymphovascular invasion were histopathological parameters. We analysed adjuvantmedical and nuclear treatment and patients' outcome during follow-up period of 102 (61-144) months. The prevalence rates of I-PTM were 9.4% in 395 thyroidectomy cases. Histopathological examination reported unifocal disease in 30 and multifocal disease in 7 (18%) patients. Multifocal disease was bilateral in 6 (20.1%) patients. The mean size of the PTMfoci was 4.88 mm. The rate of thyroid capsule invasion was 5.4%. All patients received a suppressive dose of LT4 to achieve a low serum TSH level. Adjuvant surgical and nuclear treatment was not performed in our cases. We did not find any negative changes in blood chemistry and ultrasound imaging, and any unfavourable events as locoregional and systemic recurrence. In conclusion, diagnosis of I-PTM is common that multifocality and bilateralism appear as pathologic features. The prognosis is excellent after surgical treatment and TSH suppression. Routine adjuvant nuclear treatment is unnecessary in majority of patients.Öğe Lenfanjiyoleiomyomatozise bağlı iki taraflı nüks spontan pnömotoraks(2013) Karapolat, Sami; Erbaş, Mesut; Dumlu, Talha; Erdem, Havva; Karapolat, Banu; Erekul, SelimPulmoner lenfanjiyoleiomyomatozis oldukça nadir görülen bir interstisyel akciğer hastalığıdır. Klinik tablo genellikle nüks spontan pnömotoraks ve progresif dispne şeklindedir. Kesin bir tedavi seçeneği olmamakla birlikte, yıllar içerisinde akciğer parankiminde oluşan multikistik destrüksiyonla solunum yetmezliğine neden olmaktadır. Otuz dokuz yaşında kadın hasta ani başlayan nefes darlığı ve yaygın göğüs ağrısı yakınmaları ile kliniğimize başvurdu. Oskültasyonda her iki akciğerde solunum seslerinde azalma tespit edildi. Akciğer grafisinde iki taraflı pnömotoraks gözlenmesi üzerine iki taraflı tüp torakostomi uygulandı. Toraks tomografisinde sağda daha fazla olmak üzere her iki akciğerde yerleşmiş birkaç ince duvarlı kistik yapı tespit edildi. Hastaya sağ posterolateral torakotomi ile büllektomi, apikal kama rezeksiyonu, apikal parietal plörektomi ve geri kalan plevral alanlara mekanik plevral abrazyon yapıldı. Hastada bir ay sonra oluşan sol nüks pnömotoraks nedeni ile sol posterolateral torakotomi ile büllektomi, bül ligasyonu, apikal kama rezeksiyonu, apikal parietal plörektomi ve geri kalan plevral alanlara mekanik plevral abrazyon uygulandı. Histopatolojik inceleme ile hastaya lenfanjiyoleiomyomatozis tanısı konuldu. İki yıllık takip süresinin sonunda pnömotoraks nüksü gözlenmedi. İki taraflı nüks spontan pnömotoraks gelişen premenopozal kadınlarda lenfanjiyoleiomyomatozis mutlaka akılda tutulmalıdır. Bu hastalarda konservatif yöntemlerle pnömotoraksın sıklık ile nüks etmesi nedeni ile erken dönemde cerrahi tedavi yapılmalıdır.Öğe Prevention of Pulmonary Complications of Pneumoperitoneum in Rats(Biomed Central Ltd, 2011) Karapolat, Sami; Gezer, Suat; Yıldırım, Ümran; Dumlu, Talha; Karapolat, Banu; Özaydın, İsmet; Sarıtaş, AyhanBackground: Carbon dioxide (CO(2)) pneumoperitoneum facilitates the visualization of abdominal organs during laparoscopic surgery. However, the associated increase in intra-abdominal pressure causes oxidative stress, which contributes to tissue injury. Objective: We investigated the ability of the antioxidant and anti-inflammatory drug Erdosteine to prevent CO(2) pneumoperitoneum-induced oxidative stress and inflammatory reactions in a rat model. Methods: Fourteen female adult Wistar albino rats were divided into a control group (Group A, n = 7) and an Erdosteine group (Group B, n = 7). Group A received 0.5 cc/day 0.9% NaCl, and Group B received 10 mg/kg/day Erdosteine was administered by gavage, and maintained for 7 days prior to the operation. During the surgical procedure, the rats were exposed to CO(2) pneumoperitoneum with an intra-abdominal pressure of 15 mmHg for 30 min. The peritoneal gas was then desufflated. The rats were sacrificed following 3 h of insufflation. Their lungs were removed, histologically evaluated, and scored for intra-alveolar hemorrhage, alveolar edema, congestion, and leukocyte infiltration. The results were statistically analyzed. A value of P < 0.05 was considered statistically significant. Results: Significant differences were detected in intra-alveolar hemorrhage (P < 0.05), congestion (P < 0.001), and leukocyte infiltration (P < 0.001) in Group A compared with Group B. However, the differences in alveolar edema were not statistically significant (P = 0.698). Conclusions: CO(2) pneumoperitoneum results in oxidative injury to lung tissue, and administration of Erdosteine reduces the severity of pathological changes. Therefore, Erdosteine may be a useful preventive and therapeutic agent for CO(2) pneumoperitoneum-induced oxidative stress in laparoscopic surgery.Öğe Primary Hydatid Cyst of the Chest Wall(Springer, 2012) Karapolat, Sami; Dumlu, Talha; Yıldırım, Ümran; Karapolat, Banu; Erbaş, Mesut…