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Öğe BILATERAL PRIMARY BREAST LYMPHOMA: A RARE CASE(Aves, 2011) Yetim, Ibrahim; Yetim, Tulin Durgun; Ozkan, Orhan Veli; Diner, Guvenc; Savas, Nazan; Davran, Ramazan; Helvaci, RahmiPrimary non Hodgkin's lymphoma of the breast is rare. Bilateral involvement of the breasts is even morerare. Lymphomas are divided into two groups: Hodgkin's Lymphoma and non Hodgkin's lymphoma. Diffuse large cell non Hodgkin's lymphoma is the most common type. A 56 year old female presented with masses in both breasts. An excisional biopsy was obtained from both tumoral masses. Histopathological assessment revealed diffuse large cell non Hodgkin's lymphoma and chemotherapy was started. Here we present the case of bilateral primary breast lymphoma while discussing clinical characteristics, treatment modalities and the outcomes.Öğe Cervical vertebral osteophyte as a rare cause of dysphagia: a report of three cases(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Yetim, Tulin Durgun; Karabacak, Yasemin Bilgin; Bayarogulan, Hanifi; Sengul, Aysen Taslak; Ustun, NilgunDiffuse idiopathic skeletal hyperostosis (ankylosing hyperostosis, Forestier's disease, spondylitis ossificans ligamentosa) is a chronic disease characterized by the widespread spinal osteofit formation due to enchondral ossification of paravertebral ligament and muscles. Treatment is primarily based on dietary changes and anti-inflammatory therapy in diffuse idiopathic skeletal hyperostosis patients suffering from dysphagia. Surgery should be considered in patients with a severe clinical status. In this article, we report three patients and discuss the diagnosis and treatment in the light of literature.Öğe Comparative results of surgical treatment of bullous lung diseases complicated with pneumothorax and the use of polytetrafluoroethylene graft support(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Sengul, Aysen Taslak; Yetim, Tulin Durgun; Buyukkarabacak, Yasemin Bilgin; Basoglu, Ahmet; Gundogdu, BirolBackground: This study aims to investigate the efficacy of polytetrafluoroethylene (PTFE) graft use in decreasing complications of bullous lung diseases. Methods: Between January 2004 and December 2012, 22 patients with bullous lung disease complicated with spontaneous pneumothorax were included. The patients were divided into two groups. Ten patients in group 1 had heterogeneous emphysematous disease and the 12 patients in group 2 had homogenous emphysematous disease. Both groups underwent muscle-saving thoracotomy. Wedge resection was performed by using stapler. The resection line was supported with an expandable PTFE graft in six patients in group 1 and in five patients in group 2. Treatment results and complications were compared between the groups. Results: Subtype of emphysema was the most important criterion which determined the result of the treatment. Although the use of PTFE graft support had no effect on complications in both emphysema subtypes, it shortened the duration of the chest tube withdrawal and the length of hospital stay. Conclusion: We concluded that the most important criterion which determined the treatment outcome was subtype of emphysema and this led to reduced intubation time and length of hospital stay, although use of PTFE support in both emphysema types had no effect on complications.Öğe Congenital Agenesis of the Left Lung: A Rare Case(Medknow Publications & Media Pvt Ltd, 2011) Yetim, Tulin Durgun; Bayarogullari, Hanifi; Yalcin, Hlya Polat; Arica, Vefik; Arica, Secil GunherPulmonary agenesis is a rare congenital anomaly, the etiology of which is not clearly known. Other systemic comorbidities such as cardiovascular, gastrointestinal, musculoskeletal, and urogenital system anomalies can be observed in more than half of the patients. It is usually diagnosed during childhood. Diagnosis in adulthood is very rare. We present a case of pulmonary agenesis diagnosed in an adult.Öğe Effects of platelet-rich plasma on cartilage regeneration after costal cartilage resection: a stereological and histopathological study(Acta Medical Belgica, 2017) Sengul, Aysen Taslak; Buyukkkarabacak, Yasemin Bilgin; Altunkaynak, Berrin Zuhal; Yetim, Tulin Durgun; Altun, Gamze Yayla; Sengul, Bilal; Basoglu, AhmetBackground: In cases of congenital chest wall deformities, it is important to maintain the flexibility of the chest wall after rib cartilage resection. In this study, we aimed to determine the regeneration capability of cartilage and the effects of platelet-rich plasma (PRP) on the regeneration process. Methods: A total of 16 four-week-old New Zealand rabbits were used in this study. In the 4th-5th right costal cartilages, the perichondrial sheaths were dissected and costal cartilages were excised. Then, the perichondrial sheaths were closed with absorbable material in the sham group (n = 8), and this was done after replacing PRP in the PRP group (n = 8). The left costal cartilages of the animals were used as controls. The volumes of the costal cartilages and their perichondrial sheaths were estimated using Cavalieri's principle. In addition, the mean numerical densities of the chondroblasts and chondrocytes per square millimetre were estimated using unbiased counting frames. Results: In the PRP and sham groups, the volumes of the cartilages and perichondrial sheaths were higher than those of the control group (p<0.05). The numerical densities of the chondroblasts and chondrocytes increased more in the PRP group than in the sham group (p<0.05). Conclusions: Applying PRP after resection may provide better healing and faster regeneration of cartilage.Öğe Effects of surgical and percutaneous tracheotomy on thyroid hormones(Edizioni Luigi Pozzi, 2019) Yetim, Tulin Durgun; Ozer, Gul Soylu; Karaaslan, Kerem; Yetim, Brahim; Kilic, ErolAim: To evaluate the effects of surgical and percutaneous tracheotomy on thyroid hormones. MATERIAL AND METHOD: Sixty patients with respiratory problems who underwent surgical tracheotomy and percutaneous tracheotomy between December 2012 and December 2016 were divided into 2 groups. FT3, FT4, thyroglobulin and TSH levels of the groups were statistically evaluated preoperatively and postoperatively. RESULTS: The effects of surgical and percutaneous tracheotomy on free thyroxin (FT4), serum thyroglobulin (TG) and thyroid stimulating hormone (TSH) levels were found to be statistically significant. Although free triiodothyronine (FT3) slightly elevated in both groups, it was not statistically significant. DISCUSSION: Today, percutaneous tracheotomy (PCT) and conventional surgical tracheotomy (CT) have been widely used in intensive care units on patients who are expected to be connected to mechanical ventilation for a long time. Because of the anatomy of the surgical site, tracheotomy may cause damage to the adjacent thyroid gland and tracheal rings CONCLUSION: Surgeons should keep in mind that serum thyroid hormone levels may increase postoperatively. Particularly the patients with cardiac rhythm problems should be followed after surgical and percutaneous tracheotomy due to the systemic effects of thyroid hormones.Öğe Esophagitis Corrosive Treatment of N-acetyl Cysteine Preventing Early Stricture use development activity(Aves, 2011) Yetim, Tulin Durgun; Yetim, Ibrahim; Duru, MehmetObjective: Esophageal stricture early corrosive burns to investigate the effectiveness in preventing the use of N-acetyl-cysteine. Strictures of the esophagus due to caustic substances occur with the ingestion of solid or liquid corrosive materials. Materials and Methods: A prospective randomized study was performed to evaluate the effectiveness of conventional therapy alone and conventional therapy + N-acetyl cysteine. Fifty patients with grade 2b and grade 3 burnt were analyzed. Intensive n-acetyl cysteine therapy can reduce the incidence of stricture development in patients with advanced grade corrosive esophagitis. Results: N-acetyl cysteine group+ Konvansitonel used in 1 patient, stenosis developed in 7 patients in the group with conventional treatment. Conclusion: We believe that our findings will be better supported with the groups including larger number of patients or with the experimental studies.Öğe Intralober Pulmonary Sequestration with Arterial Supply from Two Different Origins: A Case Report(Medical Tribune Inc, 2012) Erden, Ersin Sukru; Yetim, Tulin Durgun; Balci, Ali; Akcay, Adnan Burak; Hakverdi, Sibel; Demirkose, MesutPulmonary sequestration is a rare anomaly, which does not have a connection with the bronchial system and gets its blood supply, generally, from the aorta or its branches. Anatomically, two different forms were described: intralobar and extralobar. Although 74% of intralobar pulmonary sequestrations get their blood supply from the descending thoracic aorta, they may get their blood supply from different arteries. Furthermore, there is more than one arterial anomaly in 14.8% of cases. We report an intralobar pulmonary sequestration, in which arterial blood supply is from two different origins (Arcus aorta and celiac trunk). To the best of our knowledge, this is the first case in the literature.Öğe Investigation of the effect of intercostal blockade in palliation of pain in patients with rib fracture(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Yetim, Tulin Durgun; Yetim, Ibrahim; Duru, MehmetBackground: This study aims to investigate the effect of intercostal nerve blockade on pain in patients with rib fracture and its effect in reducing the opioid use requirement. Methods: Between August 2008 and July 2010, 120 patients with rib fractures in Antakya State Hospital and Mustafa Kemal University, Faculty of Medicine were included in this clinical randomized prospective study. Patients were divided into two groups. Group 1 (n=60) received tramadol (200 mg/day) and lornoxicam (8 mg/day). In group 2 (n=60), intercostal nerve blockade (0.5% bupivakain 3 ml) was performed in addition to tramadol (50 mg/day) and lornoxicam (8 mg/day) treatment. Scores of patient satisfaction visual analogue scale (VAS) were recorded both at rest and during coughing. At the end of 24 hours, total amount of tramadol used and the number of analgesic demands were recorded. Results: No statistically significant difference in VAS scores between the two groups was observed (p<0.05). However, the amount of tramadol used and the number of analgesic demand were significantly lower in the intercostal nerve blockade group (p<0.05). Conclusion: We concluded that intercostal blockade in the pain management in patients with rib fractures was effective in decreasing the dosage of opioid and thus reducing side effects which might occur.Öğe Liver hydatid cyst leading to bilateral pulmonary artery embolism and bilateral multiple pulmonar echinococcosis via inferior vena cava: report of a case(Elsevier Science Inc, 2013) Bayarogullari, Hanifi; Davran, Ramazan; Cavus, Yeliz; Yetim, Tulin Durgun; Evirgen, OmerHydatid disease (HD) is a worldwide parasitic disease. Echinococcosis may involve many organs but affect most commonly liver and lungs. The location of echinococcal cysts inside pulmonary artery is extremely rare. Radiologic findings range from purely cystic lesions to a completely solid appearance. Hydatid cysts (HC) can be solitary or multiple and varies size. Pulmonary artery embolism of HC can be symptomatic or asymptomatic. When symptomatic, we see the chest pain, dyspnea, cough, hemoptysis and sometimes acute cor pulmonale or sudden death secondary to massive giant pulmonary artery embolism of HC. (C) 2013 Elsevier Inc. All rights reserved.Öğe A novel electrospun nano-fabric graft allows early cannulation access and reduces exposure to central venous catheters(Sage Publications Ltd, 2013) Karatepe, Celalettin; Altinay, Levent; Yetim, Tulin Durgun; Dagli, Celaleftin; Dursun, SuatPurpose: The use of tunneled central venous catheters (CVC) as vascular access for hemodialysis treatment is increasing worldwide. We present a novel polycarbonate urethane nano-fabric graft, produced by electrospinning technology, which has self-sealing features that avoid seroma formation and allow puncturing within 48 hours. The aim of this study was to assess its advantages in a setting where late referral is common. Methods: A retrospective single center study assessed 24 implanted grafts in 24 patients with maximal follow-up of 18 months; patency rates, time to first cannulation and post-operative complications were assessed. Results: Successful access was achieved in all 24 patients within 48 hours. In 50% of the patients cannulation was performed within 24 hours without increasing the complication rate. Twelve month primary and secondary patencies were 50% and 70.8%, respectively. Excluding early failures (within 30 days) because of surgical problems, 12 month primary and secondary patencies were 75% and 81.2% respectively. Complication and infection rates were 10.94 and 0.49/1000 dialysis procedures, respectively. No pseudoaneurysms or seromas were documented at 18 months. Conclusions: Early cannulation was successful in all patients with good 12-month primary and secondary patency rates, compared to data reported by others on polytetrafluoroethylene (PTFE) grafts. The infection rate was substantially lower than in tunneled CVCs. Therefore, the AVflo graft may improve the clinical status of dialysis patients by decreasing the exposure to CVCs.Öğe Primary Pulmonary Adenoid Cystic Carcinoma Located at the end of the Terminal Bronchiolus: Case Report(Derman Medical Publ, 2012) Yetim, Tulin Durgun; Cokmert, Suna; Bahadir, Fadime; Davran, Ramazan; Erdem, Ersin SukruPulmonary adenoid cystic carcinoma is a rare salivary gland-type malignant neoplasm of respiratory tract that is usually located in the central airways such as trachea and main bronchus. Adenoid cystic carcinoma arising from the peripheral lung is quite rare. Here, we report adenoid cystic carcinoma that developed at the end of the terminal bronchiol of the right lung lower lobe of a 52-year-old woman.Öğe Thoracic Trauma: 156 Patient Assessment(Aves, 2011) Yetim, Tulin Durgun; Yetim, Ibrahim; Duru, Mehmet; Bayarogullari, HanifiObjective: To assess trauma patients admitted to the emergency services, because a significant portion of the thoracic trauma cases make up the leading cause of death. Materials and Methods: 156 patients with chest trauma in our clinic admitted to the Antakya public hospital and medical school at the University of Mustafa Kemal between 2008-2010 were retrospectively reviewed. Of the patients, 95 were male and 61 female. The average age of patients with blunt trauma was 18-65years, and with penetrating trauma 13-55. Results: Of the admitted patients, 112 had blunt, and 44 had penetrating chest trauma. Rib fractures were present in 90 patients, clavicle in 11 patients, scapula in nine patients, and 10 patients had fracture of the sternum. In addition, flail chest deformity was detected in 20 patients. Pneumothorax was the most common intrathoracic complication in 60 patients, hemothorax in 20 patients, and lung contusion in 15 patients. 81 tubes were inserted in patients with thoracotomy, mechanical ventilation was performed in 10 patients, and thoracotomy in 6. The mean duration of hospitalization was 7-14 days. Conclusion: Patients with chest injuries and traumatology must be met and treated by a multidisciplinary team of experts in thoracic surgery, orthopedics, brain surgery and anesthesia, without losing the experience of emergency general surgery as soon as possible. Penetrating trauma, especially in the younger generation, tends to be increased.
