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    Adult Bochdalek hernia: an analysis of eight patients
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Meteroglu, Fatih; Sahin, Atalay; Oruc, Menduh; Onat, Serdar
    Background: 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.
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    A Case of Atypically Located Hydatid Cyst Eroding the Sternum
    (Bilimsel Tip Publishing House, 2014) Tezcan, Mehmet Akif; Buyruk, Recai; Sahin, Atalay
    Hydatid disease caused by echinococci is seen endemically in Turkey. Its location in tissues outside of the liver and lung is rare. Most of the mass lesions involving the sternum are malignant. We present a case of hydatid cyst located in the sternum and eroding it.
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    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, Bulent
    OBJECTIVES: 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.
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    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, Yusuf
    The 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.
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    Effects of Ecballium Elaterium on Proinflammatory Cytokines in a Rat Model of Sepsis
    (Taylor & Francis Inc, 2016) Arslan, Mehmet Serif; Basuguy, Erol; Ibiloglu, Ibrahim; Bozdemir, Eda; Zeytun, Hikmet; Sahin, Atalay; Kaplan, Ibrahim
    Objective: Ecballium elaterium (EE) is a plant from Cucurbitaceae family. Its anti-inflammatory role in sepsis is not well understood. We investigated the effects of EE on serum levels of proinflammatory cytokines and further explored the mechanisms underlying histological changes in liver and ileum following EE administration in a polymicrobial sepsis model. Methods: Thirty rats were divided into three groups of 10 rats each. Rats were subjected to sham laparotomy plus normal saline administration (control group, CG), laparotomy with cecal ligation and puncture (CLP) (sepsis group, SG), and laparotomy with CLP plus 2.5mg/kg EE administration (experimental group, EG). Twenty-four hours after laparotomy, animals underwent cardiac puncture, and blood was collected for interleukin 1 (IL-1), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-) assessment. Whole sections of liver and ileum tissues were collected for histologic examination. Results: The serum level of IL-6 was significantly lower in EG as compared to SG. Although IL-6 levels were shown a statistically significant (p < 0.0001) decline to near control values, no significant changes were observed in serum levels of IL-1 and TNF- after EE treatment. Histologic examination revealed statistically significant reduction in collagen formation (p = 0.001) on serosal surface of ileum and hepatic venous congestion (p = 0.040) in EG as compared to SG. Conclusion: EE might play a protective role in sepsis prevention and treatment by decreasing IL-6 production and reducing liver damage and may influence bacterial translocation by reinforcing intestinal barrier function.
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    Evaluation of management of postpneumonic empyema thoracis in children
    (Lippincott Williams & Wilkins, 2013) Sahin, Atalay; Meteroglu, Fatih; Eren, Sevval; Eren, Canan; Celik, Yusuf
    Background Empyema is a well-known sequelae of pneumonia, which is increasingly being reported in children despite strict management. The appropriate management remains controversial. The aim of this study was to evaluate different management options of postpneumonic empyema in children. Materials and methods A total of 330 patients were reviewed between 2002 and 2012; their ages ranged from 1.25 to 15 years, with a median age of 4.3 years. The various management procedures included thoracentesis (n=11), chest tube drainage (n=229), chest tube drainage with intrapleural fibrinolytic therapy (n=117), video-assisted thoracoscopic surgery (VATS) (n=35), and thoracotomy because of a trapped lung noted on admissions and failed procedures (n=94). Results Variable success rates were noted as follows: tube thoracotomy (48.24%), fibrinolytic treatment (68.37%), and VATS (85.71%). Postoperative complications (11.14%) included wound infection (n=10), atelectasis (n=18), delayed expansion (n=7), and need for reoperation (n=2). Four patients died (1.21%), two of them following thoracotomy, one patient after fibrinolysis, and one patient following VATS. Patients treated with thoracotomy recovered completely. Conclusion New therapeutic modalities had variable success rates in children with postpneumonic empyema. Thoracotomy is still needed as a last resort for cases unresponsive to chemical fibrinolysis and following failed thoracoscopy. (C) 2013 Annals of Pediatric Surgery.
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    Giant hydatid cysts of the lung: Analysis and surgical outcome of 67 cases
    (Medknow Publications & Media Pvt Ltd, 2013) Meteroglu, Fatih; Sahin, Atalay; Eren, Sevval; Eren, Canan
    Aims: We aimed to evaluate the results of surgical treatment of huge hydatid cysts diagnosed at our clinic. Ruptured cysts have caused severe complications. Perforation of very large cysts is always possible. These can result in fatal complications. We present our surgical experience with large hydatid cysts in this paper. Materials and Methods: We retrospectively reviewed 191 patients diagnosed as hydatid cysts who were treated surgically. Among these, 67 cases were studied with a dimension of 10 cm or more. Age, gender, symptom, ruptured or intact, dimension, quantity and radiologic findings of the cases were determined. Incipiency of complaint, postoperative morbidity and length of hospital stay for all cases were assessed. Results: The cases comprised 41 females and 26 males. The mean age was 20.20 +/- 16.13 (5-52) years. Hospital stay for the huge and ruptured cysts group was 11.21 +/- 4.04 days. The huge but unruptured cysts group had a hospital stay of 8.40 +/- 2.48 days. All patients underwent thoracotomy. Cystotomy plus capitonnage in 52 (77.61%), decortication in addition to cystotomy plus capitonage in seven (10.6%), cystotomy in six (8.6%), cystotomy plus enucleation in one and primer closure in one were carried out. Postoperative mortality was absent; however, 17 cases were complicated; atelectasis was found in five cases, prolonged air leakage in five cases, apical aseptic pleural space in three cases, empyema in two cases, hemopthisis in one case and diaphragmatic elevation in one. Conclusions: Immediate surgery is of choice in giant cysts. Possibility of complication and longer stay in the ruptured group is higher compared with simple cystic disease.
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    Inhalation of foreign bodies in children: Experience of 22 years
    (Lippincott Williams & Wilkins, 2013) Sahin, Atalay; Meteroglu, Fatih; Eren, Sevval; Celik, Yusuf
    BACKGROUND: Foreign body (FB) inhalation into airways of the respiratory system is a life-threatening condition and can be fatal. The purpose of this survey was to evaluate the types and characteristics of inhaled foreign bodies, the age distribution of children, and the outcome. METHODS: We outlined a retrospective review of hospital data of patients between 1990 and 2012. FB inhalation occurring in children 0 year to 16 years was considered for inclusion. During the study period, 1,660 patients undergoing bronchoscopy with the diagnosis of FB were included. Deaths on arrival were excluded. RESULTS: Of the patients, 53% were male, and 47% were female (p > 0.05). The mean age was 6.2 years for girls and 4.7 years for boys. In 57% of all cases, the children were younger than 3 years. An FB was found within the respiratory tract of 1,565 patients. The FBs were always extracted by using rigid bronchoscopy. Hospitalization was always required owing to an institutional requirement. The origin of the FBs were within the two main groups of food and objects. Food FBs included seeds, nuts, beans, and fruit parts. FB objects included pins, toy parts, and metal pieces. FB and subsequent treatment revealed that morbidity was present; however, mortality was rare. CONCLUSION: Most of the inhaled FBs were found in the bronchial tree. Children younger than 3 years are more vulnerable. There seemed to be an association between the aspirated FBs and season, geographic locality, and sociocultural environment. The removal of choice is rigid bronchoscopy under general anesthesia. That most cases of FB in children occurs under the supervision of adults indicates that the incidence and severity of airway FB inhalation can be reduced by parental education and public awareness. (J Trauma Acute Care Surg. 2013; 74: 658-663. Copyright (C) 2013 by Lippincott Williams & Wilkins)
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    Insidious Threat of Children: Esophageal Foreign Body Ingestion
    (Aves, 2014) Sahin, Atalay; Meteroglu, Fatih; Erbey, Ahmet; Sizlanan, Ahmet; Ulku, Refik
    Objective: Foreign body ingestion commonly occurs in children. Objects that may not easily pass the esophagus cause severe complications, such as impaction, perforation, and obstruction. Different methods are used for their removal. We aimed retrospectively to analyze the cases in which we performed emergent esophagoscopy. Material and Methods: Between 2002 and 2013, 732 children with suspicion of foreign body ingestion were studied. Of them, 720 underwent emergency intervention. Objects located at the first narrowing of the esophagus were removed under sedation, and the remaining objects were taken out under general anesthesia with the aid of rigid esophagoscopy. Results: The mean age of the children was 3.9 years (range 1 month and 16 years). Coins in 648 cases and a variety of objects, opaque and non-opaque, were removed under direct vision. Urgent intervention was carried out in 6 cases with dyspnea, in 2 delayed cases, and in 3 patients with esophageal perforation. Successful removal was performed in 69 patients (95.8%). Perforation occurred in 3 cases. Removal was succeeded within surgery in 2 cases (2.7%). One patient died. Conclusion: A delay in esophageal body ingestion increases the complication rate. Round batteries and objects that are non-oval, long, large, and spiky should be dealt with great attention.
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    Laparoscopic Cholecystectomy in Patients With Situs Inversus Totalis: Literature Review of Two Patients
    (Kowsar Publ, 2012) Demiryilmaz, Ismail; Yilmaz, Ismayil; Albayrak, Yavuz; Peker, Kemal; Sahin, Atalay; Sekban, Nurdan
    [Abstract Not Available]
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    Middle lobe syndrome: a retrospective analysis
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2013) Meteroglu, Fatih; Sahin, Atalay; Eren, Tahir Sevval
    Background: This study aims to evaluate the efficacy middle lobe syndrome (MLS) surgery in patients with recurrent pulmonary infections. Methods: We retrospectively reviewed 37 cases (19 females, 18 males; mean age 12.3 years; range 6 to 55 years) who underwent surgery due to MLS in Dicle University, Faculty of Medicine, Department of Thoracic Surgery between January 1994 and January 2011. The underlying etiology, symptoms of the disease, bronchoscopic and radiological findings, and the outcome of surgery were evaluated. Results: Coughing was the most common symptom. The mean duration of symptoms was 5.49 years (range, 6 months to 15 years). Indication for surgery was bronchiectasis in 33 cases, collapsed lungs in two case, and total atelectasis in two cases. No postoperative mortality was seen. The mean length of hospital stay was 7.14 days (range, 5 to 13 days). The mean follow-up was four years (range, 1 to 15 years). Infection, cough and mucus were absent after surgery. Conclusion: In MLS, lobectomy is indicated for unresolving pulmonary infections and bronchial stenosis. Patients become asymptomatic following surgery.
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    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, Atalay
    OBJECTIVES: 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.