Background: This study aims to compare methylprednisolone frequently used in the therapeutic practices of corrosive esophagus burns, sucralfate, a protective material of mucosal surfaces, and alpha lipoic acid, the most potent antioxidant in a rat model. Methods: A total of 40 female Sprague-Dawley rats were used in this study. The rats were equally divided into control, alpha lipoic acid, methylprednisolone, and sucralfate groups (n=10). A corrosive esophagus burn was created by using 10% pH:12 sodium hydroxide. No treatment was applied to the control group, and each group was given their own treatment. The treatment was continued regularly until the eighth day, when they were sacrificed. The corrosive esophagus burn lines were removed and tissue sections were stained with hematoxylin and eosin. Results: The difference in ulceration in the group treated with alpha lipoic acid was significant, compared to the other groups. The most excellent complete epithelialization and complete re-epithelialization were observed in the alpha lipoic acid group. The difference between the groups was significant, with complete re-epithelialization being the lowest in the control and methylprednisolone groups (42.9% and 12.5%, respectively) and the highest in the alpha lipoic acid group (77.8%). In terms of ulceration and re-epithelialization, comparable values were found in the alpha lipoic acid group. The main difference was that the inflammation levels in the sucralfate group were lower and more favorable than the other groups in this period. The glutathione level was significantly higher in the alpha lipoic acid group and decreased the tissue hydroxyproline level. Conclusion: Alpha lipoic acid reduces esophageal ulceration, severity and prevalence of inflammation, severity and prevalence of fibrosis, decreases tissue damage by increasing blood glutathione level, and also reduces stricture in corrosive esophagus burns in rats.

ve ortalama yaş 3,6 idi.Hasta grubunda 18 yaşın altında yutulan yabancı cisimler oldukça değişkendi, ancak % 50'si metal paradan oluşuyordu.15 yaşın üzerindeki hastalarda, kemik parçaları (% 56) ve sert gıda parçaları (% 30), daha baskındı.Yutma güçlüğü, hipersalvasyon ve boğaz ağrısı gibi semptomları olan hastalar, sert özofagoskopi ve bir magill klemp uygulanarak çıkarıldı TARTIŞMA ve SONUÇ: ÖYC'leri özellikle pediyatrik yaş grubunda görülebilen önemli bir durumdur.Tanı ve tedavide gecikme yaşamı tehdit

Bronkojenik kistler (BK) ventral foregut gelişimi sırasında ortaya çıkan nadir konjenital malformasyonlardır. Bronkojenik kistler, embriyogenez sırasında (4-6. haftalar arası) bronşiyal ağacın anormal tomurcuklanması sonucu oluşur. Çoğu bronkojenik kist mediastende köken alırken, akciğer parankiminde % 15 ile % 20 arasında görülür. Literatüre göre, alt loblarda intrapulmoner kistlerin çoğu ortaya çıkmaktadır. Ancak bronkojenik kistler genellikle orta ve üst mediastende bulunurlar. Hastamızdaki bronkojenik kist subkarinal yerleşimli idi. Dev boyutta olması ve iki hemitoraksa yayılması açısından dikkat çekici idi. Bronkojenik kistler genellikle asemptomatiktir ve sıklıkla diğer nedenlerle rutin göğüs röntgen sırasında tesadüfen tanısı konur. Erişkin yaşlara kadar tespit edilemeyebilirler. Bizim hastamız 56 yaşındaydı. Belirgin bir semptomu yoktu. Hasta öksürük nedeniyle kliniğimize başvurdu ve bronkojenik kisti tespit edildi. Bronkojenik kistin temel tedavisi cerrahi eksizyondan oluşur. Ancak, rezeksiyonun yapılamadığı durumlarda, epitel olgumuzdaki gibi soyulmalıdır.

Background: This study aims to evaluate the effectiveness of pleurodesis procedure by ensuring the expansion of the lung and occluding lung parenchyma leaks with an autologous blood patch. Methods: A total of 24 patients (17 males, 7 females; mean age 59.9±12.2 years; range, 30 to 86 years) who underwent autologous blood patch pleurodesis in our clinic between November 2015 and November 2019 were retrospectively analyzed. The patients were not eligible to undergo chemical pleurodesis due to a non-expandable lung or poor general condition. Demographic and clinical characteristics of the patients and postoperative data were evaluated. Results: The air leak stopped within 48 h after autologous blood patch pleurodesis in seven patients. The air leak significantly decreased in 13 patients, while it remained unchanged in four patients. A Heimlich valve was placed in the patients in whom the air leak stopped or significantly decreased. The follow-up chest X-rays showed that the respective lungs of these patients became completely expandable. Conclusion: Our study results suggest that the autologous blood patch procedure is a favorable option for the patients who are unable to benefit much from the conventional chemical pleurodesis methods due to contraindications to surgery or the presence of non-expandable lungs.

Aim: To evaluate pediatric patients subjected to thoracic trauma in terms of prognosis, diagnosis and treatment. Although studies on trauma in adults are aplenty, those on the pediatric population are rarely available. Material and Methods: 261 patients who were exposed to thoracic trauma for any reason in the last 24 hours of hospital admission were included. The patients’ demographic data, etiology, treatments and results were retrospectively evaluated. Results: Our sample consisted of 85 girls and 176 boys with a mean age of 9.73±5.71 (range: 1-18 years). 228 of the patients (87%) had blunt trauma, 26 (10%) had penetrating trauma, and 7 (3%) had both penetrating and blunt trauma. Rate of penetrating trauma was about 4 times higher in boys. Traffic accidents were the most common reason for traumas. The most commonly fractured ribs were the 6th-9th ribs. 75 patients (28.7%) required tube thoracostomy, and 12 required open surgery. Rigid bronchoscopy was performed in 12 patients. Conclusion: None of the 33 patients with penetrating trauma died, contrary to the information in the literature. We found boys to be exposed to trauma more than girls (B/G: 2.07/1), albeit at different rates compared to the findings of other research. The development of rib fractures was found to be a predisposing factor for hemothorax. Hemothorax was observed in the 6th-9th ribs and in ≥4 rib fractures.

ÖzBronkojenik kistler (BK) ventral foregut gelişimi sırasında ortaya çıkan nadir konjenital malformasyonlardır.Bronkojenik kistler, embriyogenez sırasında (4-6.haftalar arası) bronşiyal ağacın anormal tomurcuklanması sonucu oluşur.Çoğu bronkojenik kist mediastende köken alırken, akciğer parankiminde % 15 ile % 20 arasında görülür.Literatüre göre, alt loblarda intrapulmoner kistlerin çoğu ortaya

Amaç: Yabancı cisim aspirasyonu (YCA) pediatrik yaş grubunda sık görülen ciddi bir sorundur.Tanı ve müdahale de gecikme hayatı tehdit eden bir duruma neden olabilir.Biz bu çalışmamızda kliniğimizde YCA tanısı almış ve tedavisi yapılmış

GEREÇ VE YÖNTEM: Çalışmamızda Ekinokokus Granülosus (EG) ile enfekte 9 adet sığır akciğerlerden elde edilen 45 adet canlı kist kullanıldı. Canlı akciğer kistlerinin radyofrekans tedavi grupları ısıya göre, rasgele üç ana gruba ayrıldı. Grup 1 (n=15) 90°C ‘de, grup 2 (n=15) 100°C ‘de ve grup 3 (n=15) 110°C ‘de. Gruplar radyofrekans uygulama süresine göre, üç alt gruba ayrıldı (7 dakika n=5; 9 dakika n=5; 11 dakika n=5). Tedaviden sonra tüm kistler çıkarıldı ve patolojik olarak incelendi. Eğer patolojik olarak korunmuş bir germinal membran mevcut ise kistler canlı olarak değerlendirildi. Germinal membran nekrotik ise başarılı bir şekilde tedavi edilmiş olarak değerlendirildi.

AMAÇ: Radyofrekans termal ablasyon (RTA), diğer komorbiditeleri olan inoperabl hastalarda sıklıkla kullanılan minimal invaziv bir tekniktir. Eks vivo çalışmanın amacı, hayvan modellerinde (eksplante edilen organlar) akciğer kistik ekinokokkozun tedavisinde RTA'nın farklı sıcaklık ve sürelerinin etkinliğini değerlendirmektir. GEREÇ VE YÖNTEM: Enfekte sığır akciğerleri toplandı. 9 adet sığır akciğerinde bulunan 45 adet canlı kist kullanıldı. Canlı akciğer kistlerinin radyofrekans tedavi grupları ısıya göre, rasgele üç ana gruba ayrıldı. Grup 1 (n = 15) 90°C 'de, grup 2 (n = 15) 100°C 'de ve grup3 (n = 15) 110 °C 'de. Gruplar radyofrekans uygulama süresine göre, üç alt gruba ayrıldı (7 dakika n = 5; 9 dakika n = 5; 11 dakika n = 5). Tedaviden sonra tüm kistler çıkarıldı ve patolojik olarak incelendi. Eğer patolojik olarak korunmuş bir germinal membran mevcut ise kistler canlı olarak değerlendirildi. Germinal membran nekrotik ise başarılı bir şekilde tedavi edilmiş olarak değerlendirildi. BULGULAR: RTA uygulanan 45 numunenin 41'nin patolojik kesitlerinde germinal membran kısmi olarak nekrotik durumdaydı ve canlı olarak değerlendirildi. Sadece 4 numunede tamamen nekrotik germinal membran mevcuttu ve 11 dakikada 110 ° C'de başarılı bir şekilde tedavi edildi. Yıkım oranı, RTA’da uygulanan ısı artışıyla pozitif korelasyon göstermektedir (Phi = 0.89, p = 0.006). SONUÇ: 110 ° C'ye kadar RTA uygulaması kist hidatiklerin öldürülmesinde etkili olmayabilir. Bu tekniğin, insanda kistik ekinokokkoz tedavisi olarak kabul edilmeden önce hala büyük miktarda ek klinik öncesi çalışma gerektirmektedir.

The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest-X- Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).

The most commonly employed radiologic method in diagnosis of pleural diseases is conventional chest radiograph. The commonest chest- X-Ray findings are the presence of pleural effusion and thickening. Small pleural effusions are not readily identified on posteroanterior chest radiograph. However, lateral decubitus chest radiograph and chest ultrasonography may show small pleural effusions. These are more efficient methods than posteroanterior chest radiograph in the erect position for demonstrating small amounts of free pleural effusions. Chest ultrasonograph may be able to help in distinguishing the pleural pathologies from parenchymal lesions. On chest radiograph pleural effusions or pleural thickening may obscure the visibility of the underlying disease or parenchymal abnormality. Thus, computed tomography (CT) may provide additional information of determining the extent and severity of pleural disease and may help to differentiate malign pleural lesions from the benign ones. Moreover, CT may provide the differentiation of parenchmal abnormalities from pleural pathologies. CT (coronal and sagittal reformatted images) that also show invasion of chest wall, mediastinum and diaphragm, as well as enlarged hilar or mediastinal lymph nodes. Standart non-invasive imaging techniques may be supplemented with magnetic resonans imaging (MRI).

Introduction The aim of the study was to evaluate the results of surgery to remove huge mediastinal masses and their pathology. Surgical resection was chosen for accurate diagnosis and treatment of the huge mediastinal masses extending into the pleural cavity. Methods Records were reviewed for eight patients who had the diagnosis of huge benign mediastinal masses and who underwent operation; details of the patients and operations were recorded. Results Mean age was 34.5 (range 22 to 44) years, and male-to-female ratio was 2:6. Computed tomography and magnetic resonance imaging (MRI) were used to evaluate the location and extent of the abnormality and to characterize the tissue components of the mass. Most of the tumors were located in the posterior mediastinum. The most frequent presenting symptom was exertional dyspnea. The majority of cases underwent posterolateral thoracotomy, and complete resection was possible in seven patients. Partial resection could only be performed in one. The mean diameter of the resected masses was 15 × 10 cm. Histopathologic examination revealed 3 neurogenic tumors, 2 teratomas, 1 thymolipoma, and 1 ectopic thyroid, and 1 hemangioma. Minor complication was seen in two cases. Conclusion The presurgical thoracic MRI provided correct diagnosis along with radiologic characterization and topography. Surgery must be the preferred treatment in huge benign mediastinal masses.

Acute disruption of the thoracic aorta due to blunt chest trauma is a life-threatening injury. The majority of patients with an aortic tear die at the scene while approximately 15-20% of the victims reach the hospital alive. A 25 years old man was admitted to emergency service because of traffic accident. On the chest X ray; left pleural effusion, left apical pleural cap, the evanescence of aortic knob and aorticopulmonary window, mediastinal widening (> 8 cm), tracheal deviation to right side were seen. The patient was transferred to the operating room by the diagnosis of aortic rupture. At the operation, the tear was seen on proximal site of subclavian artery pointed from aorta. After the primary repair, the patient arrested. The cardiac rescucitation was performed but he didn't answer. In this case, we aimed that the chest x-ray is useful measurement in the radiological evaluation of the traumatic aortic rupture.

DOI: 10.4328/JCAM.1056 Received: 30.04.2012 Accepted: 15.05.2012 Printed: 01.05.2015 J Clin Anal Med 2015;6(3): 387-8 Corresponding Author: Bayram Altuntas, Regional Education and Reserach Hospital, Department of Thoracic Surgery 25000, Erzurum, Turkey. E-Mail: draltuntas@hotmail.com Ozet Ana brons rupturu ile sonuclanan kunt gogus travmalari oldukca nadirdir ve muhtemelen yuksek bir hastane oncesi mortaliteye sahiptir.. Bu yaralanmalar, solunum zorlugu ve eslik eden yaralanmalardan dolayi yuksek oranda mortaliteye sahiptir. Alti yasinda erkek cocugu, kunt toraks travmasindan dolayi klinigimize kabul edildi. Baska bir merkezde sag pnomotoraks nedeniyle tup torakostomi uygulanan hasta yetersiz akciger ekspansiyonu nedeniyle klinigimize refere edilmis. Fizik muayenede orta duzeyde interkostal retraksiyon, tasipne ve siyanoz mevcuttu. Gelis anindaki direkt akciger grafisinde sagda total pnomotoraks vardi ve hilus inferiora yer degistirmisti. Hastaya rijid bronkoskopi yapildi ve sag ana bronsta total ruptur goruldu. Hastaya sleeve ust lobektomi yapildi. Brons rupturlerinde erken tani ve tedavinin onemini vurgulamayi amacladik.

Parabronchial or midesophageal diverticulum is a saclike bulging of the midesophageal wall into the periesophageal space. This bulging usually occur secondary to mediastinal inflammation. We report a case of a midesophageal diverticulum in a 21-year-old man. We discuss midesophageal diverticulum and review the literature findings.

Hydatid cyst is an infectious disease caused by cestodes. The organs most frequently involved are the liver and lung (70% and 25%, respectively). The other organs are affected by less than 10%. The spleen, kidneys, bile ducts, mesentery, heart, brain, vertebral column, ovaries, pancreas, gallbladder, thyroid gland, breast and muscloskeletal system or soft tissue are less frequently involved. In this article, we report a 49-year-old female patient with a histopathologically proven hydatid cyst which was located in the right thoracic outlet region. To our knowledge, a primary hydatid cyst of the thoracic outlet without invasion to the adjacent structures has not been previously reported.

ÖZ Amaç: Bu çalışmada ameliyat öncesi dönemde kemoterapi gören tavşanlarda bir immünstimülan olan beta glukanın bronş anastomozuna etkileri araştırıldı. Ça­lış­ma­pla­nı:­Bu çalışmada kırk beş Yeni Zelanda türü erkek tavşan kullanıldı. Tavşanlar her birinde 15 tavşan olacak şekilde grup 1 (kontrol), grup 2 (kemoterapi) ve grup 3 (kemoterapi + beta glukan) olarak üç gruba bölündü. Tüm gruplarda sol ana bronş tam olarak kesildi ve daha sonra uç uca anastomoz yapıldı. Grup 2’de ameliyat öncesi birinci günde sisplatin ve ameliyat öncesi birinci, ikinci ve üçüncü günde etoposid uygulandı. Grup 3’te aynı kemoterapi protokolüne ilave olarak ameliyattan yedi gün önceden başlanarak sakrifikasyonların bir gün öncesine kadar enteral yolla 10 mg/kg/gün beta glukan verildi. Tavşanlar ameliyat sonrası üçüncü, beşinci ve yedinci günlerde beşerli gruplar halinde sakrifiye edildi. Bronşiyal anastomoz hatları çıkarıldı ve doku kesitleri hematoksilin ve eozin ile boyandı. Bul gu lar: Patolojik incelemede grup 1 ve grup 2 arasında ve grup 2 ve grup 3 arasında istatistiksel olarak anlamlı farklılık var iken grup 1 ve grup 3 arasında bronş iyileşmesi açısından farklılık yok idi. So­nuç:­ Kemoterapi tedavisi sırasında beta glukan kullanılması ameliyat sonrası dönemde bronşiyal iyileşmeyi düzeltebilir. Anah­tar­söz­cük­ler: Bronkus; kanser; kemoterapi; sleeve lobektomi. ABSTRACT Background:­This study aims to investigate the effects of an immunostimulant, beta glucan, on the bronchial anastomosis in rabbits that received chemotherapy in preoperative period. Methods: Forty-five New Zealand male rabbits were used in this study. The rabbits were divided into three groups as group 1 (control), group 2 (chemotherapy), and group 3 (chemotherapy + beta glucan) with 15 rabbits in each group. The left main bronchus was incised completely and then endto-end anastomosis was performed in all groups. Cisplatin was administered on the preoperative first day and etoposide was administered on the preoperative first, second, and third days in group 2. In group 3, in addition to the same chemotherapy protocol, 10 mg/kg/day beta glucan was administered via enteral route starting from seven days before operation until one day before sacrifications. The rabbits were sacrificed at postoperative third, fifth, and seventh days by groups of five. The bronchial anastomosis lines were removed and tissue sections were stained with hematoxylin and eosin. Results:­In pathological analysis, while there were statistically significant differences between group 1 and group 2 and between group 2 and group 3, there was no difference between group 1 and group 3 in terms of bronchial healing. Conclusion:­ The use of beta glucan during chemotherapy treatment may improve bronchial healing at postoperative period.

OZET Mediastende hava bulunmasi ‘’Pnomomediastinum’’ olarak tanimlanmaktadir. Siddetli kunt toraks travmalarindan sonra % 10 oraninda pnomomediastinum goruldugu bildi- rilmistir. Bu tablo kendiliginden olusabilecegi gibi, travmatik olarak da olusabilmektedir. Kendiliginden olusan ve spontan pnomomediastinum olarak da ifade edilen sekli, ge- nellikle genc erkeklerde ve nadir gorulur. Travmatik pnomomediastinum ise, genellikle toraks travmalari ve servikal travmalar sonucunda herkesde gorulebilmektedir. Klinigi degiskenlik gosteren pnomomediastinumun tanisinda gogus agrisi, nefes darligi ve sub- kutan amfizem semptomlarinin ucunun olmasi onemlidir. Biz toraks travmasi neticesinde bilateral pnomotoraksin eslik ettigi pnomomediastinum- lu bir hasta sunuyoruz. Anahtar kelimeler: Pnomotoraks; Pnomomediastinum; Travma ABSTRACT Presence of air in the mediastinum is called ‘Pneumomediastinum’. It was reported that pneumomediastinum occurs at a rate of 10% as a result of severe blunt thoracic trauma. This may present either spontaneously or traumatic. The one which occurs spontaneously , also known as spontaneous pneumomediastinum, is rare and usually prefers young males. However, traumatic pneumomediastinum may occur in both genders after thoracic and cervical trauma. Pneumomediastinum has variable clinical findings and it is important for the diagnosis to document all of the following three components: chest pain, dyspnea and subcutaneous emphysema. We present a patient with pneumomediastinum accompanied by bilateral pneumothorax as a result of chest trauma. Keywords: Pneumothorax; Pneumomediastinum; Trauma

Tiroid kitlesinin %50’den buyuk bolumunun sternal centigin altinda; mediasten icinde olmasi retrosternal guatr olarak adlandirilmaktadir (1). Elli sekiz yasinda kadin hasta yaklasik 10 yildir olan nefes darligi ve progressif olarak artan efor dispnesi ile basvurdu. Yapilan tetkiklerinde posterior mediastene uzanim gosteren retrosternal guatr tespit edildi. Torakotomiye gerek duyulmadan servikal yaklasim ile total tiroidektomi yapildi. Operasyon sonrasi 3. gunde hasta sorunsuz sekilde taburcu edildi.