Amac: Bu calismada tavsanlarda rifamisin plorodezis etkinligi arastirildi. Ca­lis­ma­ pla­ni:­ Calismada ortalama agirliklari 3433 g olan toplam 21 adet erkek Yeni Zelanda turu albino tavsan kullanildi. Bir adet tavsan kan temininde kullanildi. Diger 20 tavsan kontrol grubu, heterolog kan grubu, rifamisin grubu ve talk grubu olarak dort gruba ayrildi. Tavsanlara gruplarina gore sol hemitoraksa takilan kateterden distile su, heterolog taze kan, rifamisin ve steril sivi talk verildi. Yirmi sekizinci gunde tavsanlar yuksek doz anestezi ile sakrifiye edildi. Plevrada makroskopik olarak plorodezis varligi ve mikroskopik olarak plevral kalinliklari olculdu ve inflamasyon ve fibrozis bulgulari arastirildi. Plorodezis derecesi 0’dan 4’e kadar olan skalada degerlendirildi. Bul gu lar: Makroskopik ve mikroskopik seviyede kontrol grubu ile heterolog kan grubu arasinda istatistiksel olarak anlamli fark bulunmadi (p>0.05). Talk ve rifamisin grubunda plorodezis derecesi kontrol ve heterolog kan grubundan daha yuksek idi (p=0.04). Rifamisin grubu ile talk grubu arasinda makroskopik ve mikroskopik incelemede anlamli fark bulunmadi (p>0.05). Plevral fibrozis kalinliginin medyan degerleri kontrol, heterolog kan, rifamisin ve talk gruplari icin sirasiyla 10 (10-29), 26 (10-71), 312 (264-351) ve 304 (238-331) μm olculdu. So­nuc:­Tavsanlarda rifamisin plorodezis etkinligi mikroskopik ve makroskopik olarak talk grubu ile benzer; kontrol ve heterolog kan grubuna gore daha ustun bulundu. Anah tar soz cuk ler: Rifamisin; heterolog kan; plorodezis; talk. Background:­ In this study, we aimed to investigate the efficacy of rifamycin pleurodesis in rabbits. Methods: A total of 21 male New Zealand-type albino rabbits with an average weight of 3433 grams, were used in the study. One rabbit was used for blood supply. The other 20 rabbits were divided into four groups, including the control group, the heterologous blood group, the rifamycin group, and the talc group. Distilled water, heterologous fresh blood, rifamycin, and sterile liquid talc were administered through the catheter to the left hemithorax of rabbits. The rabbits were sacrificed using high-dose anesthesia on day 28. The pleural spaces were grossly assessed for evidence of pleurodesis and microscopic thickness of the pleura, and evidence of inflammation and fibrosis were examined. The degree of pleurodesis was rated on a scale of 0 to 4. Results:­No statistically significant differences were observed between the control and heterologous blood groups at the macroscopic and microscopic level (p>0.05). The degree of pleurodesis in the talc and rifamycin groups was higher than in the control and heterologous blood group (p=0.04). No significant difference was observed between the talc and rifamycin groups in terms of macroscopic and microscopic examination (p>0.05). The median values of fibrosis thickness of the control, heterologous blood, rifamycin, and talc groups were 10 (10-29), 26 (10-71), 312 (264-351) and 304 (238-331) μm, respectively. Conclusion:­The efficacy of rifamycin pleurodesis in rabbits was microscopically and macroscopically similar to the talc group and superior to the control and heterologous blood group.

Pneumothorax progresses quickly in newborns and can lead to death. This study collected data prospectively over a 2-year period on risk factors, clinical course and prognostic factors of newborn cases diagnosed and treated for pneumothorax. Thirty patients were evaluated for risk factors including concurrent disease, method and duration of chest drainage, oxygen saturation and mechanical ventilation. Pneumothorax developed mostly in male and mature infants during the first 48 h following birth; risk factors included concurrent respiratory distress syndrome and meconium aspiration. Mechanical ventilation was undertaken in 18 (60%) of the patients. Closed-tube drainage was used in 28 (93%) of the patients. Nine out of 10 patients (90%) whose oxygen saturation remained < 90% died. Thus, pneumothorax may develop during the neonatal period, especially in the presence of risk factors, and neonates with < 90% oxygen saturation, despite treatment, have a high mortality rate.

Emergency Department, complaining of exertional dyspnea. A review of his medical history revealed that 3 years earlier he had tried to swallow a knife. It was removed from the esophagus by endoscopy. Two years before admission he told his relatives that he had swallowed another knife, but they did not believe him. Posteroanterior (Fig. 1) and lateral (Fig. 2) views of the chest were obtained, demonstrating a knife-like object in the right main bronchus. A rusty knife without its handle, measuring 5 × 2 cm, was removed from the right main bronchus by bronchoscopy. His postoperative course was uncomplicated. Although the most extraordinary objects have been inhaled or swallowed by mentally challenged people, we have not seen a case like this reported in the literature.■ Surgical Images Imagier chirurgical

A retrospective analysis of 230 cases of empyema thoracis which occurred in our clinic during the last 14 years have been presented. The causes, the pathogen organism, treatment with antibiotic are enumerated. The surgical treatment carried in resistant cases have been described Ten patients (4.34 percent) died due to respiratory failure and septic shock. Importance of early and appropriate treatment has been stressed.

Hydatid cysts are common in Turkey. Authors have seen 248 cases of lung hydatid cysts; Fifty hydatid cyst of lung had ruptured. Their symptoms and detailed findings are reported. Rupture caused asphyxia in 3, haemoptysis in 20, lung abcess in 16, rupture in pleural cavity in 4 and anaphylactic reaction in one case.

An eleven-year-old boy was operated on for a left-sided pulmonary artery aneurysm. The same patient had also been operated three years earlier because of a right sided aneurysm.

Between December, 1983, and December, 1988, 100 patients (54 men, 46 women) with acute arterial embolus, ranging in age from twenty-three to eighty- three years, were treated in our clinics. The main symptom of the patients was pain (94 % ), followed by coldness (72%), pallor (64%), sensory defect (42%), motor disorder (37%), muscular rigidity (10%), and tissue necrosis (7%). We have determined the etiology to be atrial fibrillation in 53 cases, 36 of which arose from mitral stenosis: acute myocardial infarction (MI) in 14 cases; thromboembolus based on arteriosclerosis obliterans (ASO) in 27 cases; and tumor embolus in 2 cases; 4 cases could not be explained etiologically. The most common site of embolism was the femoral artery (33%). Arterial exploration was done under local anesthesia in the 76 patients who did not have distal localization of the embolus. Embolectomy was performed in 49 of these cases and embolectomy plus localized tromboendarterectomy in 27. Owing to developing necrosis, amputation was necessary in 6 cases—4 above the knee and 2 above the elbow. Motor and sensory defect persisted to various degrees in 27 cases. The death rate was 4%.

Four patients with cystic hydatids located in pericardium and myocardium were admitted. Cardiac tamponade was determined in 1 of these cases. Surgical treatment was instituted for all cases. Transpericardial cardiac palpation was emphasized in cases where thoracotomy was necessary due to the lung cystic hydatids.

Between 1976 and 1986 one hundred and ten children with pulmonary hydatid disease were treated surgically. Sixty five of the patients were males and 45 were females. We diagnosed hydatid cyst in 36 cases submitted in our clinic with hemoptysis. Thirty of the patients had cough, 16 had chest pain and dyspnea, 12 had purulent sputum and 8 cases had fever and anaphylactic phenomena. In most of the patients hydatid cysts were localised in the right lung. However, they had affinity for the lower lobes of both lungs, rather than the upper lobes. The radiological examination was found to be the most reliable diagnostic method. In the majority of our cases we performed thoracotomy + cystotomy + capitonnage, while in some cases we performed resection, like cystectomy, wedge resection and lobectomy. We did not encounter any serious operative and postoperative complications, except for one pleural empyema and a single case of mortality.

196 cases of peripheral arterial injury presented to our clinic between 1976 and 1986 are summarised. Most of the cases were between 11 and 30 years of age and most of the injuries were by fire-arms and sharp weapons. The most common localisations were a. femoralis (29% cases), a. poplitea and branches (28%), a. brachialis injury (20%). The most common surgical measures were end-to-end anastomosis (43% cases) and venous orthograft replacement (17%). There were 5 mortalities. Factors affecting treatment success are discussed.