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Öğe Application of autologous blood patch in patients with non-expanded lungs and persistent air leak(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2020) Apiliogullan, Burhan; Dumanli, Ahmet; Ceran, SamiBackground: 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.Öğe Bilateral pnömotoraksın eşlik ettiği travmatik pnömomediastinum: Olgu sunumu(2014) Apilioğulları, Burhan; Kuru, Murat; Ceran, SamiMediastende hava bulunması Pnömomediastinum olarak tanımlanmaktadır. Şiddetli künt toraks travmalarından sonra % 10 oranında pnömomediastinum görüldüğü bildirilmiştir. Bu tablo kendiliğinden oluşabileceği gibi, travmatik olarak da oluşabilmektedir. Kendiliğinden oluşan ve spontan pnömomediastinum olarak da ifade edilen şekli, genellikle genç erkeklerde ve nadir görülür. Travmatik pnömomediastinum ise, genellikle toraks travmaları ve servikal travmalar sonucunda herkesde görülebilmektedir. Kliniği değişkenlik gösteren pnömomediastinumun tanısında göğüs ağrısı, nefes darlığı ve sub- kutan amfizem semptomlarının üçünün olması önemlidir. Biz toraks travması neticesinde bilateral pnömotoraksın eşlik ettiği pnömomediastinumlu bir hasta sunuyoruz.Öğe The comparison of alpha lipoic acid with methylprednisolone and sucralfate in subacute wound healing corrosive esophagus-induced rats: An experimental study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2023) Gultekin, Mustafa; Ceran, Sami; Gultekin, BurcuBackground: 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.Öğe A comparison of the efficacies of heterologous blood, rifamycin, and talc as pleural sclerosants in rabbits: An experimental study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Dongel, Isa; Sunam, Guven Sadi; Kulahci, Ozgur; Ceran, SamiBackground: 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) mu m, 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.Öğe Complete right main bronchus rupture in a child: Report of a case(2015) Bayram, Altuntaş; Ceran, Sami; Güven, Sunam Sadi; Cinici, ÖzkanAna bronş rüptürü ile sonuçlanan künt göğüs travmaları oldukça nadirdir ve muhtemelen yüksek bir hastane öncesi mortaliteye sahiptir.. Bu yaralanmalar, solunum zorluğu ve eşlik eden yaralanmalardan dolayı yüksek oranda mortaliteye sahiptir. Altı yaşında erkek çocuğu, künt toraks travmasından dolayı kliniğimize kabul edildi. Başka bir merkezde sağ pnömotoraks nedeniyle tüp torakostomi uygulanan hasta yetersiz akciğer ekspansiyonu nedeniyle kliniğimize refere edilmiş. Fizik muayenede orta düzeyde interkostal retraksiyon, taşipne ve siyanoz mevcuttu. Geliş anındaki direkt akciğer grafisinde sağda total pnömotoraks vardı ve hilus inferiora yer değiştirmişti. Hastaya rijid bronkoskopi yapıldı ve sağ ana bronşta total rüptür görüldü. Hastaya sleeve üst lobektomi yapıldı. Bronş rüptürlerinde erken tanı ve tedavinin önemini vurgulamayı amaçladık.Öğe The effects of preoperative chemotherapy and beta glucan on bronchial anastomosis in rabbits: A preliminary study(2015) Altuntaş, Bayram; Ceran, Sami; Sunam, Güven Sadi; Gültekin, Mustafa; Esen, Hacı HasanBackground: 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 end- to-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.Öğe Giant Benign Mediastinal Masses Extending into the Pleural Cavity(Thieme Medical Publ Inc, 2016) Sunam, Guven Sadi; Oncel, Murat; Ceran, Sami; Odev, Kemal; Yildiran, HuseyinIntroduction 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 x 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.Öğe Imaging of pleural diseases: evaluation of imaging methods based on chest radiography(Turkish Assoc Tuberculosis & Thorax, 2017) Poyraz, Necdet; Kalkan, Havva; Odev, Kemal; Ceran, SamiThe 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).Öğe Nörojenik tümörü taklit eden nadir bir özofagus duplikasyon kisti: Olgu sunumu(2012) Döngel, İsa; Bayram, Mehmet; Metin, Bayram; Ceran, Sami; Sunam, Güven SadiGastrointestinal sistem (GİS) kaynaklı duplikasyon kisti, nadir görülen konjenital lezyonlardır. Gastrointestinal sistemin anormal kanalizasyonu sonucu oluşurlar. GİS boyunca herhangi bir yerde görülebilirler, fakat en sık sağ posterior mediastene yerleşirler. Tesadüfen çekilen PA akciğer grafisinde patoloji saptanan bayan hasta kliniğimize 20 yaşındaki yönlendirildi. Sağda ekstrapulmoner yerleşimli paravertebral bölgede, azygoözefageal resese uzanan kistik yapıdaki lezyon sağ torakotomi ile çıkarıldı. Histopatolojik tanısı özofagus duplikasyon kisti olarak raporlandı. Eşlik eden başka bir patoloji mevcut değildi. Bu çalışmada paravertebral yerleşimli kistik lezyonların ayırıcı tanısının yapılabilmesi ve literatür bilgileri eşliğinde duplikasyon kistinin değerlendirilmesi amaçlandı.Öğe Parabronchial Diverticulum of Esophagus: Report of a Case(2015) Altuntaş, Bayram; Uyanıkoğlu, Ahmet; Ceran, Sami; Sunam, Güven Sadi; Metin, BayramParabronşiyal ya da midözefagiyal divertiküller, özefagusun orta kesiminin periözefagiyal alana doğru kese şeklinde büyümesi sonucu ortaya çıkar. Bu büyüme genellikle mediastinel inflamasyona sekonder olarak oluşur. Biz, midözefagiyal divertikülü olan yirmibir yaşında erkek hastayı sunuyoruz. Literatür bilgileri eşliğinde bu özefagiyal patolojiyi tartışmayı amaçladık.Öğe Plevral hastalıkların görüntülenmesi: Akciğer grafisi temelinde görüntüleme yöntemlerinin değerlendirilmesi(2017) Poyraz, Necdet; Kalkan, Havva; Ödev, Kemal; Ceran, SamiPlevra kaynaklı patolojilerin değerlendirilmesinde kullanılan birincil tanı yöntemi konvansiyonel akciğer radyografisidir. Sıklıkla görülen plevra patolojisi plevral kalınlaşma ve efüzyondur. Arka ön akciğer radyografisi (PA, posteroanterior) küçük miktardaki plevral efüzyonu göstermeyebilir. Lateral dekübitus radyografisi ve toraks ultrasonografisi (USG) az miktardaki plevral efüzyonu ortaya koymada daha etkin yöntemlerdir. PA radyografide tek taraflı homojen yoğunluk artışı gösteren olgularda toraks ultrasonografisi plevral ve parankimal patolojilerin ayırıcı tanısında yararlı bilgiler vermektedir. Akciğer radyografisinde saptanan plevral efüzyon veya kalınlaşma altta yatan hastalığı veya parankimal patolojiyi gizleyebilir. Bu nedenle bilgisayarlı tomografi (BT) plevral hastalığın yaygınlığını ve nedenini ortaya koymada yararlı bilgiler sağlamaktadır. BT(koronal ve sagital reformat görüntüler) plevral kalınlaşma veya efüzyonla birlikte bulunan parankimal lezyonların ayırt edilmesini sağlayabilir. Ayrıca BT göğüs duvarı, mediasten ve diyafragma invazyonunu, hiler ve/veya mediastinal lezyonları ayrıntılı olarak gösterebilir. Manyetik rezonans görüntüleme (MRG) standart noninvaziv yöntemlerin yetersiz kaldığı olgularda tamamlayıcı yöntem olarak kullanılabilir.Öğe Toraks travmalarına bağlı gelişen hemotoraksta tedavi yöntemleri(Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi, 1996) Avvuran, Naciye Simsen; Ceran, SamiGöğüs duvarı travmaları Türkiyede ve dünyada tüm insanlar için önemli bir problemdir. Geçmişte toraks yaralanmalarına genellikle savaşta rastlanmaktaydı. Fakat son zamanlarda trafik kazalarından dolayı sivil yaşamda da sıklıkla görülmektedir. Kunt veya penetre yaralanmalar toraks travmasına sebeb olabilir. Penetre yaralanmalarda teşhis daha kolaydır. Kunt travmalarda daha fazla tanı metodlarına ihtiyaç duymaktayız. Toraks travmalı bir hastada çok dikkatli olunmalıdır. Önce süratle hava yolu sağlanmalı, trakeobronşiyal sekresyonlar aspire edilmeli, hastanın bilinci kapalı ise endotrakeal entübasyon yapılmalıdır. Sonra majör kanamalar kontrol edilmeli ve durdurulmalıdır. Toraks travması sonrası oluşan hemotoraksın tedavisi, ponksiyon, drenaj, erken veya geç torakotomidir. Toraks travmalı vakaların büyük bir kısmı konservatif yöntemle tedavi edilebilir. Eğer hastanın kanamasını bu yolla kontrol altına alamazsak torakotomi yapılır. Bu çalışmada Ocak 1983, Aralık 1995 yıllan arasında kliniğimizde yatırılarak tetkik ve tedavisi yapılmış 1201 toraks travmalı hastada komplikasyon olarak gelişen hemotoraks ve hemopnömotorakslı 617 hastanın tedavi yöntemleri incelenerek sonuçlar retrospektif araştırılmıştır. 617 hastanın 587'sine (%95.14) konservatif tedavi edildi. 30 vaka (%4,86) erken veya geç dönemde operasyona alındı.Öğe Traumatic Aortic Rupture(Modestum Ltd, 2015) Altuntas, Bayram; Ceran, Sami; Sunam, Guven SadiAcute 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.Öğe Traumatic Aortic Rupture(Modestum Ltd, 2015) Altuntas, Bayram; Ceran, Sami; Sunam, Guven SadiAcute 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.Öğe Unusual location of hydatid cyst: Thoracic outlet(2015) Altuntaş, Bayram; Ceran, Sami; Şener, EbruKist hidatik, sestodların neden olduğu infeksiyöz bir hastalıktır. En sık tutulan organlar karaciğer ve akciğerdir (sırasıyla %70 ve %25). Diğer organlar %10dan daha az etkilenir. Dalak, böbrekler, safra yolları, mezenter, kalp, beyin, vertebral kolon, yumurtalıklar, pankreas, safra kesesi, troid bezi, meme ve kas-iskelet sistemi veya yumuşak doku daha az tutulur. Bu yazıda, histopatolojik olarak ispatlanan, sağ torasik outlet bölgesinde kist hidatiği olan 49 yaşında bir kadın hasta sunuldu. Bilgilerimize göre, torasik outlette çevre dokulara yayılmayan bir kist hidatik daha önce sunulmamıştır.
