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An Atypical Neurofibroma in the Posterior Mediastinum: A Case Report
(Düzce Üniversitesi, 2011) Gezer, Suat; Yıldırım, Ümran; Dumlu, Talha; Balbay, Oner; Kandiş, Hayati; Özaydın, İsmet; Karapolat, Sami
Nerve sheath tumors such as neurofibroma, schwannoma, and perineurioma are relativelyuncommon lesions that sometimes constitute an interesting diagnostic and therapeutic problemin the clinical practice.A 27-year-old male patient was operated for a mass located in the left posterior mediastinum.The mass was resected by a thoracotomy, and a diagnosis of atypical neurofibroma was revealedhistopathologically. He has been well without any problems in his 6 months postoperativeperiod.Intrathoracic neurogenic tumors should be resected surgically due to the possibility ofmalignancy. Complete resection can be performed safely by a thoracotomy approach and isnecessary for achieving a cure
An atypical neurofibroma in the posterior mediastinum: A case report
(2011) Karapolat, Sami; Gezer, Suat; Yıldırım, Ümran; Dumlu, Talha; Balbay, Öner; Kandiş, Hayati; Özaydın, İsmet
Nerve sheath tumors such as neurofibroma, schwannoma, and perineurioma are relatively uncommon lesions that sometimes constitute an interesting diagnostic and therapeutic problem in the clinical practice. A 27-year-old male patient was operated for a mass located in the left posterior mediastinum. The mass was resected by a thoracotomy, and a diagnosis of atypical neurofibroma was revealed histopathologically. He has been well without any problems in his 6 months postoperative period. Intrathoracic neurogenic tumors should be resected surgically due to the possibility of malignancy. Complete resection can be performed safely by a thoracotomy approach and is necessary for achieving a cure. © 2011 Düzce Medical Journal.
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, Selim
Pulmonary 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.
Effects of Erdosteine on Experimental Acute Pancreatitis Model
(Coll Physicians & Surgeons Pakistan, 2017) Karapolat, Banu; Karapolat, Sami; Gürleyik, Emin; Yaşar, Mehmet
Objective: 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.
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, Hayati
Background. 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).
Effects of Urtica dioica on hepatic ischemia-reperfusion injury in rats
(Hospital Clinicas, Univ Sao Paulo, 2010) Kandiş, Hayati; Karapolat, Sami; Yıldırım, Ümran; Sarıtaş, Ayhan; Gezer, Suat; Memişoğulları, Ramazan
OBJECTIVES: To evaluate the effects of Urtica dioica on hepatic ischemia-reperfusion injury. METHODS: Thirty adult male Wistar albino rats were divided into three groups: sham group (group 1), control group (group 2), and Urtica dioica group (group 3). All the rats were exposed to hepatic ischemia for 60 min, followed by 60 min of reperfusion. In group 2, a total of 2 ml/kg 0.9% saline solution was given intraperitoneally. In group 3, a total of 2 ml/kg Urtica dioica was given intraperitoneally. At the end of the procedure, liver tissue and blood samples were taken from all rats. Serum aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, ceruloplasmin, catalase, paraoxonase, arylesterase, and lipid hydroperoxide levels were measured. Liver tissue histopathologies were also evaluated by light microscopy. RESULTS: Serum aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase levels were significantly higher in group 2 than in group 1, and significantly lower in group 3 than in group 2. Also, group 2 had higher serum lipid hydroperoxides and ceruloplasmin levels but lower catalase, paraoxonase, and arylesterase levels than group 1. In group 3, serum lipid hydroperoxides and ceruloplasmin levels were significantly lower, and catalase, paraoxonase, and arylesterase levels were higher than those in group 2. Histopathological examination showed that liver tissue damage was significantly decreased in group 3 compared with group 2. CONCLUSIONS: Urtica dioica has a protective effect on the liver in hepatic ischemia-reperfusion-injured rats.
Entübasyon Sonrası Gelien Trakeal StenozunAnestezi Yönetimi ve Cerrahi Prosedürü
(2013) Erbaş, Mesut; Ateş, Hakan; Gezer, Suat; Karapolat, Sami; Aydın, Leyla Yılmaz; Öztürk, Ömür; Demiraran, Yavuz
Endotrakeal tüp veya trakeostomi kanüllerinin kafları fazla volümde hava ile i irildikleri takdirde temas halinde oldukları hava yollarına basınç uygulayarak mukozada travmaya yol açmaktadırlar. Sonuçta bu bölgede çember eklinde nekroz alanı ve skatris-striktür olu ması ile ciddi bir klinik durum olan semptomatik trakeal stenozlar meydana gelmektedir. Yirmi dört ya ında erkek olgu nefes darlı ı ve hırıltılı solunum ikâyetleri ile acil servise ba vurdu. Anamnezde yakın zamanda yüksekten dü me nedeniyle yo un bakım ünitesinde entübe olarak takip ve tedavi edildi i ö renilen olgunun fizik muayenesinde inspiratuvar wheezing ve stridor tespit edildi. Arter kan gazında pH: 7.31 ve pO2: 68.7 mmHg idi. Anterior-posterior ve lateral boyun grafilerinde trakeal stenoz alanı görüldü. Bilgisayarlı tomografide trakeanın ba langıcında 22 mm uzunlu unda ve en dar yerinde 3,5 mm çapında olan stenotik segment izlendi. Olguya kollar insizyon ile stenotik segment rezeksiyonu ve uç uca anastomoz uygulandı. Postoperatif dönemde komplikasyon geli meyen olgu 7. gün taburcu edildi. Klinik, radyolojik ve bronkoskopik olarak tam iyile me gözlenen olgu 1 yıllık takibin sonunda halen asemptomatiktir. Uzun süreli entübasyonlarda yüksek kaf basıncına ba lı olarak geli en trakeal stenozlar ciddi solunum sıkıntısı ve ya am kalitesinde bozulmaya yol açmaktadırlar. Cerrahi olarak yapılan stenotik segmentin rezeksiyonu ve uç uca anastomoz tekni i etkili bir anestezi yönetimi ve postoperatif bakımla birle tirildi inde ba arılı sonuçlar alınabilmektedir.
The evaluation of Pat-Pat related injuries in the western black sea region of Turkey
(Biomed Central Ltd, 2011) Karapolat, Sami; Sarıtaş, Ayhan; Kandiş, Hayati; Çıkman, Mehmet; Gezer, Suat; Özaydın, İsmet; Dumlu, Talha
Background: Accidents caused by motorized vehicle in the agricultural sector are frequently observed. In Turkey; accidents arising from motorized vehicles, named Pat-Pat, which are used by farmers in the Western Black Sea region is not unusual. Methods: One hundred five patients who were brought into the Emergency Department of Duzce University, Medical Faculty Hospital between September 2009 and August 2010 due to Pat-Pat related accidents were evaluated. Results: The cases consisted of 73 (69.5%) males and 32 (30.5%) females, ranging from 2 to 73 years of age. In the 10-39 age group, a total of 63 (60.0%) cases were determined. The months when the greatest rate of cases applied to the hospital consisted of July, August, September and the season is summer. The cases were exposed to trauma in roads in 54 (51.4%), and 51 (48.6%) occurred in agricultural area without roads. Eighty seven (82.9%) cases were injured due to the overturning of vehicle. The patients were brought to the hospital using a private vehicle in 54 (51.4%) of the cases and in 51 (48.6%) cases, 112 ambulance system was used. The cases were determined to apply to the hospital most frequently between 6 pm-12 am. The injuries frequently consisted of head-neck and spine traumas, thorax traumas and upper extremity traumas. In 55 (52.4%) cases, open wound-laceration was determined. Seventy five (71.4%) cases were treated in the Emergency Department, and 28 (26.7%) were hospitalized. Three (2.9%) cases were deceased. Conclusions: Serious injuries can occur in Pat-Pat related accidents, and careful systematic physical examination should be conducted. In order to prevent these accidents, education of farm operators and engineering studies on the mechanics and safety of these vehicles should be taken and legal regulations should be created.
Evaluation of Quality of Life After Bilateral Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis
(Wroclaw Medical Univ, 2010) Şanlı, Aydın; Önen, Ahmet; Karapolat, Sami; Eyüboğlu, Gün Murat; Taşdöğen, Aydın; Ulugün, İlknur; Özdemir, Nezih
Background. Primary hyperhidrosis is a disorder from which 1% of the society suffers. Objectives. This present study is aimed to evaluate the effects of endoscopic thoracic sympathectomy on the primary hyperhidrosis. Material and Methods. Between February 2008 and April 2010, 30 patients with primary hyperhidrosis underwent endoscopic thoracoscopic sympathectomy. Before the operation, 4 (13.3%) cases had sweating on scalp with flushing on the forehead. There was primary palmar hyperhidrosis in 25 (83.3%) cases, facial hyperhidrosis in 17 (56.6%) cases and primary plantar hyperhidrosis in 19 (63.3%) cases. The second and the third thoracic sympathetic ganglia were bilaterally cauterized in 6 (20.0%) of the cases, while 2(nd), 3(rd) and 4(th) thoracic sympathetic ganglia were bilaterally cauterized in 24 (80.0%) cases. Results. Quality of life was evaluated by Hyperhidrosis Disease Severity Scale in preoperative and postoperative period. Before the operation, 10 (33.3%) cases expressed that hyperhidrosis was barely tolerable followed by 20 (66.7%) cases expressing that hyperhidrosis was intolerable. After the operation, compensatory sweating was never noticeable in 8 (26.6%) cases, tolerable in 15 (50.0%) cases, barely tolerable in 5 (16.7%) cases, intolerable in 2 (6.6%) cases. In order to assess the quality of life before and after the operation, a scale between 1 (very poor) and 10 (very good) has been implemented. It was found that average before the operation was 7 (2-8), while average after the operation was 8.2 (6-10) (P < 0.001). Conclusions. Endoscopic thoracic sympathectomy is most efficient treatment method of primary hyperhidrosis for enhancing the quality of life (Adv Clin Exp Med 2010, 19, 5, 619-624).
GERIATRIC POPULATION AND FORENSIC TRAUMAS
(Gunes Kitabevi Ltd Sti, 2011) Kandiş, Hayati; Karakuş, Ali; Katırcı, Yavuz; Karapolat, Sami; Kara, İsmail Hamdi
Introduction: The lessening in the functions of body by aging increases traumatic injury risk. Materials and Method: The cases of the age 65 and over, who referred to Kirikkale High Specialization Hospital Emergency Service, between January 2007-June 2009, and had undergone forensic trauma were evaluated from the points of sex, age, monthly cumulative distribution, cause of trauma, way of transferring, pathologies, Glasgow coma scale, follow up duration, rates of hospitalization and mortality. Results: Of the 224 cases, 155 (69.2%) were male and 69 (30.8%) were female. The range of age was 65-98. Most of the cases occurred between 5th-8th months. Motor-vehicle accident was the most frequent cause. 178 (79.5%) cases were taken to hospital by private automobiles. Soft tissue injury was the most frequent pathology. The mean score of Glasgow coma was 14.5 +/- 1.6. The follow up duration time was 4.8 +/- 2.2 hours. 38 (17%) cases were hospitalized and followed 5.4 +/- 3.5 days. 8 cases (3.6%) were died. Conclusion: After comprehensive physical examination, the necessary tests of geriatric trauma patients should be done and the follow up should be prolonged. Also, it is necessary not to avoid hospitalization that should be kept under control during the follow up and early period.
Geriatrik yaş grubu ve adli travmalar
(2011) Kandiş, Hayati; Karakuş, Ali; Katırcı, Yavuz; Karapolat, Sami; Kara, İsmail Hamdi
Giriş: Yaşlanma ile vücut fonksiyonlarında oluşan azalma travmatik yaralanma riskini artırmaktadır. Gereç ve Yöntem: Kırıkkale Yüksek İhtisas Hastanesi Acil servisine Ocak 2007 – Haziran 2009 tarihleri arasında başvuran 65 yaş ve üstü adli travma olguları; cinsiyet, yaş, aylık kümülâtif dağılım, travma nedeni, hastaneye getiriliş şekli, travma sonucu oluşan patolojiler, Glaskow koma skoru, gözlem süresi, hastaneye yatış oranları ve mortalite açısından değerlendirilmiştir. Bulgular: 224 olgunun 155'i (%69.2) erkek ve 69'u (%30.8) kadındı. Olguların yaşları 65 ile 98 arasındaydı. Olguların çoğunluğu 5-8. aylar arasında görülmüştür. Travma nedeni olarak en sık trafik kazası tespit edildi. Olguların 178'i (%79.5) özel araçla hastaneye getirilmişti. Oluşan patolojiler içinde en sık yumuşak doku travması gözlendi. Glaskow koma skoru ortalaması 14.5 1.6 idi. Olguların ortalama gözlem süreleri 4.8 2.2 saatti. 38 (%17) olgu hastaneye yatırıldı ve ortalama 5.4 3.5 gün takip edildi. Takipte 8 (%3.6) olgu kaybedildi. Sonuç: Yaşlı travma olgularında daha kapsamlı yapılacak fizik muayene sonrası gerekli görülen tetkikler tamamlanmalı ve bu olguların gözlem süreleri daha uzun tutulmalıdır. Ayrıca takip ve erken dönemde kontrol edilmesi gereken olguların hastaneye yatırılmalarından kaçınmamak gerekmektedir.
Histological Investigation of the Effects of Tenoxicam on Pulmonary Complications of Pneumoperitoneum - Tenoxicam Reduces Lung Injuries Caused by Pneumoperitoneum
(Wroclaw Medical Univ, 2011) Gezer, Suat; Karapolat, Sami; Yıldırım, Ümran; Türüt, Hasan; Erbaş, Mesut; Özaydın, İsmet
Objectives. Pneumoperitoneum increases intra-abdominal pressure and generates oxidative stress, which mediates tissue injury. One of the causes of oxidative stress production is an inflammatory reaction. Taking this into consideration, the current animal study was designed, using tenoxicam before a laparoscopy procedure in order to ascertain whether tenoxicam can prevent lung injury caused by pneumoperitoenum. Material and Methods. Fourteen female Wistar rats were randomly divided into two groups: the tenoxicam group (seven rats) and the control group (seven rats). The tenoxicam group was given two doses (totalling 0.5 mg/kg) of intraperitoneal tenoxicam, and the control group was given 0.5 cc of 0.9% NaCl, 12 hours and 1/2 hour before the operation. Under intra-peritoneal anesthesia, a Veress needle was placed in the peritoneal cavity and a 15 mm-Hg pneumoperitoneum was established and maintained for 20 minutes; the peritoneal gas was then desufflated. The lungs were resected at the 180(th) minute from the beginning of the operation and were evaluated histopathologically. Histopathological evaluations including intra-alveolar hemorrhage, alveolar edema, congestion and leukocyte infiltration were carried out for both groups. Results. A statistical comparison of the evaluation scores revealed significant differences between the two groups for intra-alveolar hemorrhage (p = 0.007), alveolar edema (p = 0.023) and congestion (p = 0.005) and a nonsignificant difference for leukocyte infiltration (p = 0.114). Conclusions. Pneumoperitoneum causes injuries to lung tissue; tenoxicam reduces that damage and protects the lungs by decreasing intra-alveolar hemorrhage, alveolar edema and congestion (Adv Clin Exp Med 2011, 20, 4, 503-507).
The histopathological evaluation of mediastinal lymph node stations in sarcoidosis
(Drunpp-Sarajevo, 2012) Karapolat, Sami; Yıldırım, Ümran; Karapolat, Banu; Erbaş, Mesut
Background: 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.
Is standard cervical mediastinoscopy still a valuable operation?
(Drunpp-Sarajevo, 2012) Karapolat, Sami; Erbaş, Mesut; Yıldırım, Ümran; Gezer, Suat
Background: Mediastinoscopy is a widely used surgical procedure in the diagnosis of mediastinal disease and the staging of lung cancer. Objective: To question the feasibility of mediastinoscopy procedure at a newly established thoracic surgery center. Methods: Fifty patients who underwent mediastinoscopy at the Thoracic Surgery Clinic of Duzce University School of Medicine, between January 2009 and January 2011 were reviewed retrospectively. Results: In a majority of cases, mediastinoscopy was conducted with diagnostic purposes, and frequently, sarcoidosis and tuberculosis diagnoses were made. Among patients with malignancy who had mediastinoscopy for staging purposes, N2 or N3 were determined in half of them. In mediastinoscopy, which has a 98% success rate, 16% morbidity rate was determined, where hoarseness due to nervus laryngeus recurrens damage and pneumothorax are frequently observed. There was no mortality among patients. Conclusions: Although mediastinoscopy may cause various complications in newly established thoracic surgery centers, it is an essential surgical procedure that should be routinely applied to patients.
Lenfanjiyoleiomyomatozise bağlı iki taraflı nüks spontan pnömotoraks
(2013) Karapolat, Sami; Erbaş, Mesut; Dumlu, Talha; Erdem, Havva; Karapolat, Banu; Erekul, Selim
Pulmoner 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.
Management of traumatic pneumothorax
(2010) Karapolat, Sami; Gezer, Suat; Aydın, Leyla Yılmaz; Dumlu, Talha; Kandiş, Hayati
[No abstract available]
Mediastinal masses; the analysis of 28 cases in the western black sea region
(2013) Gökçe, Mertol; Saydam, Özkan; Kılıçgün, Hacı Ali; Karapolat, Sami; Gezer, Suat
Amaç: Mediastinal kitleler hayati organlara yakın olması ve çeşitli histopatolojik tipler içermesinden dolayı çok önemlidir. Bu çalışmanın amacı, cerrahi olarak tanı konulan ve rezeksiyon yapılan mediastinal kitleli olguları retrospektif olarak analiz etmektir. Gereç ve Yöntem: Mayıs 2008-Aralık 2011 tarihleri arasında, Batı Karadeniz bölgesinde ki üniversite hastaneleri göğüs cerrahisi kliniklerimizde mediastinal kitle nedeniyle operasyon uygulanan 28 hasta retrospektif olarak incelendi. Olgular yaş, cinsiyet, şikâyet, klinik ve radyolojik bulgular, cerrahi yaklaşım, histopatolojik tanı, postoperatif komplikasyon ve mortalite açısından incelendi. Olguların yaş aralığı 31-76 arasında (ortalama: 52,07) ve 19’u kadın, 9’u erkek toplam 28 hastadan oluşuyordu. Başvuru şikâyetleri öksürük, göğüs ağrısı, kas güçsüzlüğü ve dispne idi. Bir olguda vena kava süperior sendromu vardı. Olguların %21,4’ü asemptomatikti. Olguların %85,72’sine komplet rezeksiyon yapılırken, %14,28’ine ise yalnızca biyopsi yapılabildi. Postoperatif komplikasyon bir olguda görüldü ve mortalite izlenmedi. Sonuç: Cerrahi tedavi, mediastinal kitlelerin kesin tanı ve tedavisinde düşük mortalite ve morbidite oranı ile güvenilir bir yöntemdir.
Mediastinal masses; the analysis of 28 cases in the Western Black Sea Region [Mediastinal kitleler; batı karadeniz bölgesindeki 28 olgunun analizi]
(Derman Medical Publishing, 2013) Gökçe, Mertol; Saydam, Özkan; Kılıçgün, Hacı Ali; Karapolat, Sami; Gezer, Suat
Mediastinal masses are important because they are adjacent to vital structures and have various histopathologic types. In this study, the cases with mediastinal masses which were diagnosed by surgical approach and resected were analyzed retrospectively. Material and Method: 28 patients with mediastinal masses, who were operated in thoracic surgery clinics of Western Black Sea region universities between May 2008 and December 2011, were analyzed retrospectively. The cases were examined in terms of age, sex, complaint, clinical and radiologic findings, surgical approach, histopathological diagnose, postoperative complications and mortality. The cases are consisted of 19 woman and 9 men whose ages vary between 31 and 76 (median: 52,07). They were attended with cough, chest pain, muscle weakness and dyspnea. One patient had vena cava superior syndrome. 21,4% of patients were asymptomatic. Complete resection was made in 85,72% while only biopsy was performed in 14,28% of the cases. Postoperative complication was one patient and there was no mortality. Discussion: Operative therapy, a definitive diagnose and treatment of mediastinal masses is a reliable method with low mortality and morbidity rate.
Our cases of sarcoidosis diagnosed by mediastinoscopy; Western black sea experience
(2012) Kılıçgün, Ali; Karapolat, Sami; Saydam, Özkan; Gezer, Suat; Gökçe, Mertol
Amaç: Sarkoidoz etyolojisi bilinmeyen, sistemik tutulum gösteren ve nonka-zeifiye granülomlarla seyreden bir hastalıktır. Sarkoidoz tanısını mediasti-noskopi ile koyduğumuz hastalarımızı evreleri ve klinik özellikleri bakımından değerlendirdik. Gereç ve Yöntem: Kliniklerimizde (Batı Karadeniz Üniversite Hastanelerinde) mediastinoskopi ile sarkoidoz tanısı alan 38 olgu geriye dö-nük olarak incelendi. Olgular posteroanterior akciğer grafilerine göre evre-lendirildi. Hastaların başvuru şikayetleri, solunum fonksiyon testleri, tanı yön-temleri, evreleri, eşlik eden hastalık varlığı, klinik ve laboratuar özellikleri de-ğerlendirildi. Bulgular: Hastaların 26’sı kadın 12’si erkeklerden oluşmaktaydı. Ortalama yaş 49 yıl iken yaş aralığı ise 24-71 yıl idi. En sık başvuru şikayeti öksürük olarak tespit edildi, en sık radyolojik evre ise evre II idi. En sık sağ pa-ratrakeal lenf nodlarından biopsi (2R,4R) alınırken en az sol paratrakeal lenf nodlarından biopsi alındı. Mortalite izlenmedi. 3 hastada komplikasyon geliş-ti. Sonuç: Sarkoidoz tanısının genelde hiler lenfadenomegali ve akciğer pa-rankiminde infiltrasyonun bulunduğu evre II’de konulduğu görüldü. Sarkoidoz tanısında mediastinoskopi ile mediastinal lenf nodu biopsisi hızlı sonuç veren ve düşük morbidite ve mortalite ile etkili bir yöntemdir.
Our cases of sarcoidosis diagnosed by mediastinoscopy; Western black sea experience [Mediastinoskopi ile tanı konulan sarkodioz olgularımız; Batı karadeniz deneyimi]
(Derman Medical Publishing, 2012) Kılıçgün, Ali; Karapolat, Sami; Saydam, Özkan; Gezer, Suat; Gökçe, Mertol
Aim: Sarcoidosis is a multisystemic disease, characterized by noncaseating granuloms, the aetilogy remains unknown. We have stated that sarcoidosis diagnosis used by mediastinoscopy and our patients evaluated by stage and clinical features. Material and Method: 38 cases with a diagnosis of sarcoidosis by mediastinoscopy in our, clinics (University Hospitals of Western Black Sea) were retrospectively analyzed. Cases was staging according to posteroanterior chest x-rays. Admission complaints,Pulmonary Function Tests, diagnostic methods, disease stages, co-morbid diseases, clinical and laboratory features of the patients were assessed. Results: 26 of the patients were female, 12 were male. Mean age was 49 and age range was between 24-71 years. Most common complaint at appeal was cough, and the most common radiological stage was 2. The most common biopsy taken from the lymph nodes was right paratracheal (2R, 4R), the least common was the left paratracheal lymph nodes. There was no mortality. Complications developed 3 patients. Discussion: Sarcoidosis diagnoses usually settled was in stage 2 with hilar lymphadenomegalia and lung parenchymal infiltration. Mediastinoscopy in the diagnosis of sarcoidosis with mediastinal lymph node biopsy is an effective procedure with quick results, low morbidity and mortality rates. © 2012, Derman Medical Publishing. All rights reserved.

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