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Öğe Adult Bochdalek hernia: an analysis of eight patients(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Meteroglu, Fatih; Sahin, Atalay; Oruc, Menduh; Onat, SerdarBackground: This study aims to analyze congenital diaphragmatic hernias in adult age groups. Methods: We retrospectively studied files of eight patients (3 males, 5 females; mean age 31.4 years; range 18 to 53 years) of Bochdalek hernias of advanced age who were operated in our clinic between January 2005 and June 2013. Patients' age, sex, associated diseases, symptoms, surgical access, abdominal organs in the thorax, postoperative morbidity and mortality rates, and duration of hospital stay were evaluated. Results: Cough, chest pain, and dyspnea were the most common symptoms. Intestinal sounds in the thorax were present in six patients on auscultation. Pulmonary function tests, biplane chest X-rays, and thoracic computed tomography were performed. Bochdalek hernia was located on the left side in seven patients and on the right side in one patient. Posterolateral thoracotomy + laparotomy were performed in one patient, while posterolateral thoracotomy was performed in the other seven patients. No postoperative morbidity or mortality was observed. The mean duration of hospital stay was 8.75 days (range 4-25 days). Patients were followed up for a mean of 28.13 months (range 3-60 months). Conclusion: Although rarely, congenital diaphragmatic hernias may be seen in the older age groups. Life-threatening complications may develop in asymptomatic patients over time. Surgical treatment is essential upon diagnosis.Öğe Comparison of preoperative and postoperative arterial blood gas analysis, respiratory function test and lung perfusion scintigraphy of adult patients undergoing lung decortication surgery(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2012) Oruc, Menduh; Cakmak, Muharrem; Eren, SevvalBackground: In this study, we aimed to determine the effect of lung decortication surgery on the postoperative respiratory function, comparing pre- and postoperative findings of arterial blood gas analysis, respiratory function test and lung perfusion scintigraphy of the adult patients. Methods: Between January 2000 and November 2008, the clinical data of 37 patients over 15 years of age (25 males, 12 females; mean age 37.3 years; range 15 to 73 years) were retrospectively analyzed, who underwent lung decortication surgery due to chronic empyema in Thoracic Surgery Department of the Faculty of Medicine of Dicle University, Diyarbakir. Pre- and postoperative findings of arterial blood gas analysis, respiratory function test and lung perfusion scintigraphy were analyzed statistically. Results: Sixteen (43.24%) of the patients underwent right thoracotomy, while 21 (56.75%) underwent left thoracotomy. Histopathologic examination revealed chronic fibrinous pleuritis in 28 patients (75.6%) and tuberculous pleuritis in nine patients (24.3%). Statistical significance was found in PO2, SO2 (p<0.05), FEV1 and FVC and perfusion scintigram (p<0.001), whereas no statistical significance was observed in PCO2 (p>0.05). Conclusion: Our study results suggest that decortation surgery eliminates the compression on the lungs, allowing re-ventilation and leads to improvement of the respiratory function over time. These findings were also consistent with the previous study results.Öğe Do Meteorological Changes Have an Effect on The Occurence of Spontaneous Pneumothorax?(Bilimsel Tip Publishing House, 2016) Oruc, Menduh; Sahin, Atalay; Dursun, Recep; Taylan, Mahsuk; Erbey, Ahmet; Meteroglu, Fatih; Ozturk, BulentOBJECTIVES: Spontaneous pneumothorax refers to the leakage of air into the space between the parietal and the visceral layers of the pleura. It occurs with or without a known lung disease. We aimed to investigate the effects of atmospheric pressure, humidity, and temperature changes on the incidence of spontaneous pneumothorax (SP). MATERIAL AND METHODS: This study included 551 patients with spontaneous pneumothorax retrospectively screened between January 2009 and December 2013. The medical data of the patients were accessed via their medical records on the hospital automation system. The atmospheric pressure, temperature, humidity rate, amount of precipitation, and wind velocity on the day of spontaneous pneumothorax were obtained from the data provided by the general directorate of meteorology. The three consecutive days on which at least 2 cases of SP presented were collectively considered as a cluster. The study data were analyzed with the SPSS version 15 software package, using the Chi-square and the Student's t tests. A p value less than 0.05 was considered statistically significant. RESULTS: Of the 552 patients included in the study, 89.3% had primary spontaneous pneumothorax and 10.7% had secondary spontaneous pneumothorax. Ninety-two percent of the patients were male and 8% were female. The mean age was 24 years. Clustering was observed in 71.7% of the study population. No significant differences were observed between yearly and monthly SP incidences. There were, however, differences between the days with SP and the days without SP with respect to atmospheric pressure, ambient temperature, wind velocity, and humidity rate. The differences between the atmospheric pressures were not statistically significant, although the differences between the ambient temperature and the humidity rate were statistically significant (p=0.05). CONCLUSION: We determined that the changes in the ambient temperature and the humidity rate affected the rate of spontaneous pneumothorax by altering the meteorological conditions.Öğe Effect of fully charged and discharged batteries on esophageal tissue: an experimental study(E-Century Publishing Corp, 2016) Oruc, Menduh; Yilmaz, Ahmet; Ekin, Nazim; Durkan, Atilla; Sahin, Atalay; Nergiz, YusufThe aim of this study was to compare the effect of charged and discharged alkaline batteries on esophageal tissue, and to determine the impact of duration due to the exposure to alkaline batteries. Thirty-five rabbits were divided into 5 groups each containing 7 rabbits. Alkaline batteries were ingested by rabbits [except for the control group [Group 1]]. Rabbits in Group 2 were exposed to discharged alkaline batteries for 180 minutes. In Group 3-5, the fully charged batteries were left in esophagus for 60, 120, and 180 minutes, respectively. Macroscopic appearance of esophageal mucosa as well as histopathologic examination of battery induced esophageal injury and pH of environment were compared. Battery capsules were intact in each group. No color change was observed in the anode pole of batteries for Group 2. Color change was evident in the anode pole of batteries for 3 rabbits in Group 3, in 4 rabbits in Group 4, and in 7 rabbits from Group 5; while no significant change was observed in any rabbit from Group 2. Histopathologically, mucosal erosion was observed in 7 rabbits of Group 3. In Group 4, mucosal erosion extended to the internal muscular layer. Necrosis was exceeding external muscular layer in Group 5. Alkaline batteries may cause erosion as a result of electrical currency without corrosive substrate leakage. Duration of exposure is an important determinant of tissue injury.Öğe Effect of human development index parameters on tuberculosis incidence in Turkish provinces(J Infection Developing Countries, 2016) Taylan, Mahsuk; Demir, Melike; Yilmaz, Sureyya; Kaya, Halide; Sen, Hadice Selimoglu; Oruc, Menduh; Icer, MustafaIntroduction: A country's development level is measured with a quantitative parameter called the human development index (HDI). The present study researched the effects of HDI parameters (such as healthcare standards, income, and education level) on the incidence of tuberculosis. Methodology: HDI data of 36 provinces of Turkey and the tuberculosis surveillance data were obtained from the Ministry of Development and the Ministry of Health, respectively. The associations between the incidence of tuberculosis and other HDI parameters were analyzed. Results: Higher population density (n/km(2)) (CI = 0.05 to 0.40) and higher relapse rate of tuberculosis (CI = 0.36 to 1.48) were identified to be independent predicting factors that increased the incidence of tuberculosis, whereas higher gross national product (CI =- 0.06 to 0.00), the population that holds a green Medicare card(CI=-0.58 to -0.04), increased general practitioners per 100,000 people (CI=-0.66 to -0.01), female population (CI = -0.70 to -0.06), married population (CI = -1.34 to -0.03), were found to be significant negative predicting factors that were relevant to the incidence (protective against tuberculosis). Conclusions: Tuberculosis is a disease that is affected by multiple factors, including the components of HDI. Improvement of income level, facilitation of access to health services via health insurance, urbanization with lower population density strategy, and provision of enough general practitioners may be useful in reducing the incidence of TB' in provinces of developing countries such as Turkey.Öğe Evaluation of factors affecting prognosis in penetrating thoracic injuries(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2018) Oruc, Menduh; Ulku, RefikBackground: This study aims to investigate the prognostic factors affecting survival and clinical outcomes in patients exposed to pediatric penetrating thoracic injury. Methods: A total of 267 pediatric penetrating thoracic injury patients (217 males, 50 females; mean age 10.8 years; range, 3 to 17 years) who were treated at our hospital during the recent 20 years were analyzed retrospectively. Penetrating thoracic injuries were divided into three groups: incisive/stabbing injuries, gunshot injuries, explosive injuries. Patients' age, gender, New Injury Severity Score, injury type, injuries accompanying thoracic trauma, types of treatment applied, length of hospital stay, and morbidity and mortality outcomes were examined. Their prognostic characteristics were compared to their injury types, New Injury Severity Scores, lengths of hospital stay and complications. Results: Of the patients, 103 were exposed to gunshot injuries, 128 to incisive/stabbing injuries, and 36 to explosive injuries. Of the penetrating thoracic injuries, while 211 (79%) were isolated injuries, 56 (21%) were accompanying non-thoracic injuries. Mean New Injury Severity Score was 13 +/- 10. Of the patients, 50 (18.6%) were treated with medical therapy alone, 199 (74.5%) with tube thoracostomy, and 18 (6.7%) with thoracotomy. Fifty-one patients (19%) developed complications. Length of hospital was 9 +/- 2.7 days. Twenty-one patients (7.9%) died. New Injury Severity Scores, rates of combined injuries, complications, length of hospital stay, and mortality were higher in explosive injuries (p<0.05). Conclusion: Pediatric penetrating thoracic injuries may be observed in all age groups in children, the most severe type being explosive injuries. Prognostic factors may vary according to injury type, complications, treatment approach, and presence of accompanying non-thoracic injuries.Öğe A rare complication of acupuncture: pneumothorax(Turkish Assoc Tuberculosis & Thorax, 2014) Demir, Melike; Oruc, Menduh; Dalli, Ayse; Kaya, Halide; Karadeniz, Gulistan[Abstract Not Available]Öğe The Role of Duration of Hyperbaric Oxygen Therapy on Lung Injury: An Experimental Study Lung Injury and Hyperbaric Oxygen Therapy(Bilimsel Tip Publishing House, 2018) Oruc, Menduh; Esen, Bennur; Taylan, Masuk; Nergis, Yusuf; Sahin, AtalayOBJECTIVES: We aim to histopathologically analyze the effect of hyperbaric oxygen (HBO) therapy in the lung tissue. MATERIAL AND METHODS: A total of 21 rabbits were divided into three groups, with each containing seven rabbits. Group 1 was the control group. Group 2 underwent HBO of 3 atmosphere absolute (ATA) for 90 min/day for 7 days. In group 3, HBO at 3 ATA was administered 90 min/day for 28 days. Oxygen saturation (SpO(2)) was determined by pulse oximetry before and after administration of HBO. Rabbits were sacrificed, and the apex of the right lung was excised. RESULTS: SpO(2) was 98-100% in all rabbits before HBO administration. After the procedure, the mean SpO(2) was 92% and 83% in groups 2 and 3, respectively. As expected, histopathologic examination in group 1 was normal. In group 2, congestion in the lung vessels, mononuclear cell infiltration in the bronchial mucosa, interstitial edema, and alveolar dilation were evident. Histopathologic examination in group 3 indicated diffuse alveolar edema, peribronchial mononuclear cell infiltration, thickening of the alveolar and vessel wall, and intraalveolar hemorrhage. CONCLUSION: There is a strict relationship between duration of HBO administration and severity of lung injury.Öğe Thoracic Wall Necrotizing Fascitis in a Neonate: a Case Report(Derman Medical Publ, 2010) Onat, Serdar; Avci, Alper; Ulku, Refik; Oruc, Menduh; Ozcelik, CemalNecrotizing fasciitis (NF) is a rapidly progressive and potentially life-threatening infection of superficial fascia and subcutaneous tissue. Thoracic wall is one of the rarest locations for NF. Broad-spectrum antibiotics receiving, early surgical debridement, and skin grafting are life saving in NF. We report a 7-day-old female neonate who had left sided thoracic wall NF. She had undergone extensive surgical debridement within 4 hours of hospital admission, and reconstruction of skin defect by split-thickness skin grafting later. Early diagnosis is important, as prompt surgical debridement offers the best chance for survival. Early and extensive surgical debridement is a widely accepted clinical approach and the mainstay of effective treatment. The goals of surgical intervention are to remove all necrotic tissues, and to help control the progression of NF. Reconstruction of skin defects should be performed by early split-thickness skin grafting like our patient or primary closure. Because early wound resurfacing prevents fluid, electrolyte, and protein loss from the wound site, and decreases secondary infection. Although chest wall NF is rare in neonates, it is a rapidly spreading, highly lethal infection. A high index of suspicion, early diagnosis, and aggressive approach are essential to its successful treatment.Öğe Unexpected complication of oesophagoscopy: iatrogenic aortic injury in a child(Clinics Cardive Publ Pty Ltd, 2016) Tezcan, Orhan; Oruc, Menduh; Kuyumcu, Mahir; Demirtas, Sinan; Yavuz, Celal; Karahan, OguzIntroduction: Oesophagoscopy is usually a safe procedure to localise and remove ingested foreign bodies, however, unexpected complications may develop during this procedure. In this case report we discuss iatrogenic aortic injury, which developed during oesophagoscopy, and its immediate treatment. Case report: A six-year-old male patient was admitted to hospital with symptoms of having ingested a foreign body. Oesophagoscopy was carried out and the foreign body was visualised at the second constriction of the oesophagus. During this procedure, profuse bleeding occurred. Subsequently, a balloon dilator was placed to control bleeding in the oesophagus. Thoracic contrast tomography revealed thoracic aortic injury. Open surgical aortic repair was immediately carried out on the patient and the oesophageal hole was primarily repaired. The patient was discharged on postoperative day 15 with a total cure. Conclusion: Although oesophagoscopy is a safe, easily applied method, it should be kept in mind that fatal complications may occur during the procedure. This procedure should be done in high-level medical centres, which have extra facilities for managing complications.
