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    Clinical experience of repair of pectus excavatum and carinatum deformities
    (Clinics Cardive Publ Pty Ltd, 2013) Oncel, Murat; Tezcan, Bekir; Akyol, Kazim Gurol; Dereli, Yuksel; Sunam, Guven Sadi
    Background: We present the results of surgical correction of pectus excavatum (PE) and pectus carinatum (PC) deformities in adults, and also report a new method of sternal support used in surgery for PE deformities. Methods: We present the results of 77 patients between the ages of 10 and 29 years (mean 17) with PE (n = 46) or PC (n = 31) deformities undergoing corrective surgery from 2004 to 2011, using the Ravitch repair method. Symptoms of the patients included chest pain (15%) and tachycardia (8%). Three patients underwent repair of recurrent surgical conditions. Results: All of the patients with dyspnoea with exercise experienced marked improvement at five months post operation. Complications included pneumothorax in 5.1% (n = 4), haemothorax in 2.6% (n = 2), chest discomfort in 57% (n = 44), pleural effusion in 2.6% (n = 2), and sternal hypertrophic scar in 27% (n = 21) of patients. Mean hospitalisation was eight days. Pain was mild and intravenous analgesics were used for a mean of four days. There were no deaths. Results after surgical correction were very good or excellent in 62 patients (80%) at a mean follow up of three years. Three patients had recurrent PE and were repaired with the Nuss procedure. In three patients who underwent the Ravitch procedure, a stainless steel bar was used for sternal support instead of Kirschner wire. Conclusions: Pectus deformities may be repaired with no mortality, low morbidity, very good cosmetic results and improvement in cardiological and respiratory symptoms.
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    Giant Benign Mediastinal Masses Extending into the Pleural Cavity
    (Thieme Medical Publ Inc, 2016) Sunam, Guven Sadi; Oncel, Murat; Ceran, Sami; Odev, Kemal; Yildiran, Huseyin
    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 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.
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    MMP-2, TIMP-2, and MMP-2/TIMP-2 complex levels in epidermoid lung cancer
    (Tubitak Scientific & Technological Research Council Turkey, 2013) Oncel, Mufide; Akoz, Mehmet; Oncel, Murat; Kiyici, Aysel; Apiliogullari, Burhan
    Aim: To investigate serum levels of MMP-2, TIMP-2, and MMP-2/TIMP-2 complex in epidermoid lung cancer and determine whether one of these markers or any combination of them can be used as a prognostic factor and in the management of this disease. Materials and methods: Twenty-eight patients with non-small cell lung cancer and 21 healthy, age-matched individuals participated in this study. MMP-2, TIMP-2, and MMP-2/TIMP-2 complex levels were measured in the sera of the patients and controls with the ELISA technique. Results: MMP-2, TIMP-2, and MMP-2/TIMP-2 complex levels were significantly elevated in patients with non-small cell lung cancer compared to the controls (P = 0.018, 0.041, and 0.034, respectively). Conclusion: MMP-2, TIMP-2, and MMP-2/TIMP-2 complex levels increased not only in lung tissues, but in the sera of the patients with non-small cell lung cancer. However, further studies are needed to fully evaluate the expression rates and diagnostic efficiency of these parameters in different histopathological subtypes of this cancer and in prospective research with a large number of participants.
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    Penetrating cardiac injury in blunt trauma: a case report
    (Turkish Assoc Trauma Emergency Surgery, 2015) Dereli, Yuksel; Oncel, Murat
    Cardiac injuries may rarely be observed due to blunt thoracic traumas. Cardiac injury often creates a life-threatening condition requiring urgent surgical intervention, and follow-up of these patients should be carefully carried out in the perioperative period. These injuries depend on various factors including clinical presentation, type of injury, the time that passes until the patient reaches the hospital, bleeding, cardiac tamponade, or additional injuries. This article aimed to report a case who suffered penetrating cardiac injury in blunt thoracic trauma. Evaluated in the emergency department due to a motor vehicle accident, the 61-year-old male patient's chest x-ray revealed pulmonary contusion, rib fractures and cardiac tamponade. The patient was operated emergently. Right atrial injury was observed in the operation. The cardiac injury was repaired with primary suture technique. Cardiac injury in patients with blunt thoracic trauma is likely to be observed. In these patients, careful physical examination, early diagnosis, and treatment are very important.