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  • Küçük Resim
    Öğe
    The high risk of postintubation tracheal stenosis in patients intubated for organophosphate poisoning
    (2012) Başoğlu, Ahmet; Şengül, Ayşen Taslak; Kefeli, Mehmet; Durgun Yetim, Tülin; Bekdemir, Ömer Serdar; Kutlu, Tamer
    Amaç: Bu çalışmada entübasyon sonrası trakea stenozu gelişen hastalar, entübasyonun birincil nedeni ve tedavisine göre tekrar değerlendirildi. Çalışma planı: Ocak 2001 - Aralık 206 tarihleri arasında yoğun bakım ünitesinde çeşitli nedenler ile endotrakeal entübasyon uygulanan 230 hasta arasından entübasyon sonrası trakeal stenoz gelişen 14 hasta retrospektif olarak incelendi. Hastaların tümü boyun ve göğüs bilgisayarlı tomografi taraması ile değerlendirildi ve trakeal anastomoz yapıldı. Rezeke edilen stenotik trakeal halkalar, histopatolojik olarak değerlendirildi. Bulgular: Hastaların toplam 201’ine genel travma (GT), 29’una ise organik fosfor zehirlenmesi (OFZ) nedeni ile endotrakeal entübasyon uygulandı. On dört olguda trakeal stenoz gelişti, bu olguların dokuzu OFZ, beşi GT hastası idi. Organik fosfor zehirlenmesi olan hastalarda yüksek doz atropin veya pralidoksim tedavisi dışında, medikal tedavi ve bakım her iki grupta genel olarak benzer idi. Rezeke edilen stenotik trakeal halkalarda, yaygın kronik aktif inflamasyon, fibrozis ve epitel kaybı OFZ grubunda, GT grubundan daha fazla idi. Sonuç: Entübasyonun birincil nedeni ve medikal tedavinin, entübasyon sonrası trakeal stenoz gelişimine etkisi olabilir.
  • [ N/A ]
    Öğe
    Investigation of micrometastasis by cytokeratin staining in non-small cell lung cancer patients with tumor negative mediastinoscopic lymph node biopsies
    (Ondokuz Mayis Universitesi, 2013) Kaya, Sinan; Başo?lu, Ahmet; Büyükkarabacak, Yasemin Bilgin; Çelik, Burçin; Şengül, Ayşen Taslak; Yetim, Tülin Durgun; Yildiz, Levent
    To investigate micrometastasis by using epithelial cytokeratin marker in non-small cell lung cancer (NSCLC) patients with tumor negative mediastinoscopic lymph node biopsies. Micrometastasis were investigated by immunohistochemical staining in 20 patients who were diagnosed as NSCLC with ipsilateral mediastinal lymph nodes (RN2) in CT scan and with negative histopathologic mediastinoscopic lymph node biopsy (pN0). Frozen section was studied with hematoxylin-eosin (HE), a routine histopatological method in lymph nodes taken by mediastinoscopy and in absence of metastasis; resection was applied with thoracotomy in the same session. We studied micrometastasis in lymph nodes, which are taken out by mediastinoscopy and dissected during resection, using both HE and immunohistochemical staining with cytokeratin. All patients were male and median age was 60.9 (51-74) years. In 16 cases epidermoid carcinoma, in 2 cases adenocarcinoma and in 2 cases bronchioloalveoler carcinoma were diagnosed as histopathological types. Cervical mediastinoscopy was performed in 20 patients who were diagnosed as RN2 by thorax CT radiologically, and complete resection was done in pN0 patients. Sixty lymph nodes, 40 of them taken by mediastinoscopy and 20 taken during resection, were stained immunohistochemically in 20 NSCLC patients. Only one lymph node from a single patient was positive after staining. After postoperative staging, 18 patients were at a lower stage, one patient was at the same stage, and one patient with micrometastasis was at an advanced stage. Immunohistochemical staining may be useful in detecting micrometastasis in NSCLC. Standard cervical mediastinoscopy is still gold standard in preoperative staging. Efficiency can be increased by combining mediastinoscopy, a gold standard method in staging, with immunohistochemical methods. © 2013 OMU.
  • [ N/A ]
    Öğe
    Treatment strategy for hydatid cysts with multiorgan involvement/localization
    (Ondokuz Mayis Universitesi, 2013) Şengül, Ayşen Taslak; Büyükkarabacak, Yasemin Bilgin; Yetim, Tülin Durgun; Gürz, Selçuk; Demira?, M. Kemal; Başoglu, Ahmet
    Hydatid cyst is a parasitic disease commonly observed in developing countries. In this study, 24 patients treated for multiorgan hydatid cyst disease in our clinic between 2001 and 2011 were retrospectively evaluated. Twenty patients had hydatid cysts in lungs and liver; one had cysts in heart, lungs, and liver; one had cysts in heart and lungs; and one had cysts on left diaphragm and liver. Twenty-one patients underwent posterolateral thoracotomy. In two patients, exploration was performed via median sternotomy. During thoracotomy, five cysts located in the right lung and liver were intervened with phrenotomy. Eighteen cysts were excised by using cystotomy plus capitonnage, four by cystotomy plus pericystectomy plus capitonnage, and two by enucleation. Five of the cases were ruptured hydatid cysts. Four of these patients had received 10 mg/kg/day albendazole treatment previously due to hydatid cyst of liver. The mean hospital stay was 17 days for ruptured cysts and 7 days for non-ruptured cysts. Preoperative medical treatment in patients with multiorgan hydatid cyst causes pulmonary cyst rupture, and eventually leads to morbidity. So, it is advisable that before starting medical treatment, the lungs should be screened for hydatid cysts. © 2013 OMU.