Browsing by Author "Edirne, Yesim"

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Autologous Blood Pleurodesis: a Good Choice in Patients With Persistent Air Leak
(Wolters Kluwer Medknow Publications, 2009) Cobanoglu, Ufuk; Melek, Mehmet; Edirne, Yesim
Aim: The study compares the efficiency, side effects and complications of autologous blood pleurodesis with talcum powder and tetracycline. Materials and Methods: This prospective study evaluated 50 patients with persistent air leak resulting from primary and secssondary spontaneous pneumothorax between February 2004 and March 2009. The patients inclussded 32 (64.0) males and 18 (36.0) females with a median age of 39 years (range 14-69 years). All cases had persistent air leak of more than seven days. Pleurodesis was performed using autologous blood in 20 (40.0) patients, talc powder in 19 (38.0) patients and tetracycline in 11 (22.0) patients through a chest tube. Air leak cessation times after pleurodesis, side effects and pulmonary function tests (PFT) in the first and third months were measured. Results: Recurrent primary spontaneous pneumothorax was the cause of persistent air leak in all cases. Air leaks were expiratory only in 54.0 of cases. We obtained a success rate of 75.0 using autologous blood, 84.2 using talc powder and 63.6 using tetracycline. Mean air leak termination interval was significantly (P < 0.001) shorter in patients treated with autologous blood in comparison to talc powder and tetracycline. We observed a significant (P < 0.05) decline in PFT in patients treated with talc powder compared with tetracycline and autologous blood. Vital capacity, FVC and FEV1 were significantly lower in patients treated with tetracycline compared with autologous blood. Conclusion: This study shows that autologous blood pleurodesis compared to talc powder and tetracycline is related with shorter leak cessation time and less pulmonary function decline in patients with persistent air leak. We think further randomized clinical trials of pleurodesis as treatment could increase its use in thorax surgery by demonstrating the safety and the efficacy of this procedure.
Chest Radiography Diagnosis of Pulmonary Contusion Is Associated With Increased Morbidity and Mortality
(Springer india, 2010) Cobanoglu, Ufuk; Melek, Mehmet; Edirne, Yesim
Background: The aim of this study is to compare morbidity and mortality rates of patients with Chest Radiography (CXR) proven pulmonary contusion and normal CXR but pulmonary contusion on contrast Computed Tomography (CT). Methods: Cases were divided into two groups according to diagnosing method: CXR-proven (CXR-group) and CT-only diagnosed pulmonary contusion group (CT-group). Groups were compared for Injury Severity Score (ISS), Length Of Stay in Hospital (LOSH), length of stay in Intensive Care Unit (ICU), Arterial Blood Gas (ABG) changes, andmorbidity and mortality rates. Results: Mean LOSH and LOSI were significantly longer (23.09 +/- 4.01 and 13.42 +/- 3.47) in CXR group than in the CT group (10.97 +/- 3.27 and 3.59 +/- 1.54). Mean ISS score was significantly higher in the CXR group (38.63 +/- 9.37) than in the CT group (22.74 +/- 18.00). Mean ABG results were significantly poorer in the CXR group than in the CT group. The percentage of the cases requiring mechanic ventilation was 54.5% in the CXR group. Morbidity and mortality rates were 45.4% and 27.7% in the CXR group and 10.8% and 4.3% in the CT group, respectively. Conclusion: Diagnosis of pulmonary contusion by CXR is associated with higher morbidity and mortality rates.
Is Muscle-Sparing Thoracotomy Advantageous
(Ekin Tibbi Yayincilik Ltd Sti-ekin Medical Publ, 2011) Cobanoglu, Ufuk; Hiz, Ozcan; Melek, Mehmet; Edirne, Yesim
Background: The aim of this study was to compare muscle-sparing thoracotomy for the latissimus dorsi and the serratus anterior muscles (MST-L), and muscle-sparing thoracotomy for serratus anterior muscle (MST-S) with each other and with standard posterolateral thoracotomy (SPLT) in terms of advantages and disadvantages. Methods: Sixty patients (18 females, 42 males; mean age 42.6 +/- 16.6 years; range 15 to 72 years) in whom thoracotomy was indicated were randomly grouped into three categories. The groups were compared in terms of the effects of thoracotomy on shoulder range of motion, muscle strength, pulmonary function, postoperative pain, and duration of hospitalization. Results: Shoulder range of motion and serratus anterior muscle strength in the SPLT group were significantly lower than in the other groups. The latissimus dorsi muscle strength in the MST-L group was significantly better than that of the other groups. The parameters of pulmonary function on days 3 and 7 in the MST-L group were significantly better than those of the other groups. The duration of hospitalization in the MST-L group was significantly shorter than that of the other groups. Conclusion: The improvement of pulmonary function occurs earlier in thoracotomies that spare the chest wall muscles, and postoperative complications due to detachment are decreased. Although there is a better field of view in SPILT and MST-S than that of MST-L, considering the other advantages of MST-L, we recommend initiating with MST-L in all thoracotomies, except in emergency cases.
Landmine Associated Injuries in Children in Turkey
(Elsevier Sci Ltd, 2009) Can, Muhammet; Yildirimcan, Humeyra; Ozkalipci, Onder; Melek, Mehmet; Edirne, Yesim; Bicer, Umit; Uner, Huseyin Bulent
This study aims to examine trends of injuries due to landmines and unexploded ordnance (UXO) and to determine problems during and after the treatment of children and adolescent victims in Turkey. Data from the records of 23 children injured from landmines and UXO were analyzed from April 2001 to October 2008. Cases consist of 21 (91.3%) males and two (8.7%) females with a mean age of 12.8 years. Cause of injury was landmine explosion in 20 (87.0%) and UXO in three (13.0%) cases. Injuries in upper and lower extremities were determined in eight (34.8%) children. Hand amputation was the result in 10 (43.5%) children where in two cases a leg, in one case an eye, in one case a hand and arm, in two cases a hand and leg, in one case an eye and a leg and in three cases a hand and eye were lost. One case of death was recorded from UXO with an autopsy performed. Contaminated areas in our region should be cleared according to international contracts to prevent injuries in children, centers providing rehabilitation services should be established and policies regarding social support for child victims should be ascertained. (c) 2009 Published by Elsevier Ltd and Faculty of Forensic and Legal Medicine.
Late Recognized Nail Aspiration in a Child: Case Report
(Turkish Assoc Trauma Emergency Surgery, 2011) Cobanoglu, Ufuk; Can, Muhammed; Birincioglu, Ismail; Edirne, Yesim; Melek, Mehmet
Foreign body (FB) aspiration is common in children aged 0-3 years. Our case, a 2.5-year-old girl, presented with sudden onset of cough, fever and sputum; she had been treated twice for acute bronchitis four months ago. Resisting complaints led to an esophagoscopic examination in our Chest Surgery Clinic after a chest X-ray suggested FB in the esophagus, but no FB could be detected. A lateral chest X-ray revealed a FB with its sharp end targeting the trachea and its round end to the right hemithorax. Removal of the FB with forceps was not possible during rigid bronchoscopy. The FB was removed by thoracotomy and bronchotomy under general anesthesia. The removed FB was a nail measuring 6 cm in length. This case report should serve to stress the diversity of FB aspirations in childhood, the role of parental neglect, and that physicians should be aware of the possibility of FB in children with persistent cough.
Megacystis-Microcolon Hypoperistalsis Syndrome: a Case Report
(Hindawi Ltd, 2009) Melek, Mehmet; Edirne, Yesim; Beger, Burhan; Cetin, Mecnun
Megacystis Microcolon Intestinal Hypoperistalsis Syndrom (MMIHS) is a quite rare congenital and fatal disease which was firstly defined by Berdon and his colleagues. It appears through a widely enlarged bladder and microcolon and its cause is unknown (Berdon et al., 1976; Carmelo et al., 2005; Makhija et al., 1999; Loening-Baucke and Kimura 1999; Redman et al., 1984; Hsu et al., 2003; Yigit et al., 1996; Srikanth et al., 1993). The disease is found in females three or four times more than in males (Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). Most of the cases die within the early months of their lives (Yigit et al., 1996; Srikanth et al., 1993; Sen et al., 1993; Hirato et al., 2003). We present the case of a female newborn with antenatal ultrasound revealing intestinal mass and bilateral hydroureteronephrosis. The case was admitted for intestinal obstruction after birth. Copyright (C) 2009 Mehmet Melek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Parameters of Some of Biochemistry on Ischemia-Reperfusion Injury in Newborn Rat Intestine
(Asian Journal of Chemistry, 2010) Melek, Mehmet; Edirne, Yesim; Edirne, Tamer; Etensel, Barlas; Karaca, Irfan; Aktas, Safiye; Demir, Halit
The purpose of the present study was to determine the effects of treatment with thyroxin and dexamethasone separately and together on I/R injury in newborn rat intestine. Newborn rats were divided into five groups: (1) control (C) group, (2) sham group, (3) thyroxin (T(4)) group, (4) dexamethasone (DEX) group and (5) thyroxin plus dexamethasone (T(4)+DEX) group. Each group consisted of seven pups. Group T(4) received thyroxin I mu g/g BW/day, group DEX received dexamethasone 5 mu g/gBW/day and group T(4)+DEX received 1 mu g/gBW/day thyroxin and 5 mu g/gBW/day dexamethasone i.p. for 7 days. Group C received only physiological saline (NaCl 0.9%). Animals were sacrificed at the end of the reperfusion period and ileum samples were obtained. Malondialdehyde (MDA) levels, a product of lipid peroxidation, glutathione (GSH) levels, a key antioxidant were determined in ileum homogenates. In the jejunum, only T(4) caused a significant statistical elevation in GSH compared with control, sham and DEX groups (p < 0.05). There was significant statistical interaction between T(4) and DEX treatment, i.e. the effect of T(4) treatment was greater in both regions. Mucosal damage scores showed statistical significant effect of T(4) in the ileum compared with control and T(4)+DEX group. The same significant statistical effect was seen with T(4)+DEX group compared to the control group in the ileum. Overall, the comparison between the two regions shows a powerful effect of T(4) in both regions. There was statistical significance between the scores of T(4) in the ileum and of DEX and T(4)+DEX in the jejunum. A beneficial effect of thyroxin in all samples was observed in this study supporting its protective effects against I/R injury which was attenuated by glucocorticoid administration.
Pneumomediastinum Cases Due To Non-Traumatic Reasons
(Aves, 2009) Cobanoglu, Ufuk; Melek, Mehmet; Edirne, Yesim
Aim: Pneumomediastinum due to non-traumatic reasons develops as a result of various etiologies. In this study, we aimed to compare the etiologies, clinical courses and the effectiveness of treatment modalities in pneumomediastinum cases resulting from non-traumatic reasons. Materials and methods: The data of 19 cases with non-traumatic pneumomediastinum were evaluated retrospectively between 2001 and 2008. The effectiveness of treatment methods were evaluated by arterial blood gas and pulmonary function test. The data was analyzed by SPSS (version 16.0) using Friedman test to determine the change according to the time. Pulmonary function test (SFT) parameters on first, third and seventh days were compared with two group's variance analysis (Repeated measurement ANOVA) and after variance analysis, Duncan multiple comparison test was performed to determine the different group means. In comparisons, a p value of <0.05 was considered to be statistically significant. Results: The cases consisted of 12 male and 7 female patients. The most frequent reasons of pneumomediastinum were found to be mechanical ventilation and asthma. While tracheostomy, tube thoracostomy and subcutaneous catheterization were performed in 13 of the cases, conservative approach was preferred in 6 cases. Although pulmonary function test results of the patients with subcutaneous catheter and the ones followed conservatively showed statistically significant improvement at third and seventh days compared to the initial values (p<0.05), it was noticed that the patients with subcutaneous catheter showed a faster clinical improvement. Conclusions: This study demonstrates that subcutaneous catheterization helps to improve the clinical status of the patient via rapid air decompression and tracheostomy application contribute to obtain normal ventilation by providing mediastinal decompression in cases with pneumediastinum due to the mechanic ventilation.
Polyarteritis Nodosa With Perforation of the Cecum
(Turkish Soc Gastroenterology, 2012) Melek, Mehmet; Beger, Burhan; Simsek, Metin; Epcacan, Serdar; Kosem, Mustafa; Edirne, Yesim
Removal of Chest Tubes: a Prospective Randomized Study
(Ekin Tibbi Yayincilik Ltd Sti-ekin Medical Publ, 2011) Cobanoglu, Ufuk; Melek, Mehmet; Edirne, Yesim; Mergan, Duygu
Background: This study aims to determine which method and timing of chest tube removal is associated with a lower risk of developing recurrent pneumothorax. Methods: This prospective study was designed to evaluate the removal method and time in 144 patients (57 females, 87 males; mean age 43.2 years; range 8 to 72 years) with chest tubes inserted for trauma and other causes. Patients were randomly assigned into two groups according to the respiratory phase of the chest tube removal. Subgroups were assigned by subdividing these groups according to whether or not suction was performed and according to whether chest tube removal occurred at 6-12 hours or 24-48 hours. Results: Results supported that tube removal at the end-inspiration phase is more appropriate than removal at the end-expiration and no suction phases (p<0.013). In addition, recurrent pneumothorax was observed significantly more often in patients whose chest tubes which were removed at 6-12 hours rather than at 24-48 hours (p<0.028). The mean duration of hospital stay was significantly longer in patients with recurrent pneumothorax (p<0.01). Conclusion: Removal of chest tubes at the end of inspiration with suction and after 24-48 hours is associated with a lower rate of recurrence of pneumothorax and a significantly shorter duration of hospital stay.
Value of Bronchoscopy in Diagnosis and Treatment of Recurrent Cough and Pneumonia in Children With Foreign Body Etiology
(Bilimsel Tip Publishing House, 2008) Cobanoglu, Ufuk; Edirne, Yesim; Akgun, Cihangir; Melek, Mehmet
Introduction: We aimed to evaluate the bronchoscopy results of children with undiagnosed recurrent cough and pneumonia presumed to be due to foreign body aspiration according to the literature. Material and Method: Thirty-seven children followed by the Yuzuncu Yil University Medical Faculty with chronic cough and recurrent pneumonia not responding to medical treatment, were included in this study between 2004-2008. Bronchoscopy was carried out with a rigid/flexible bronchoscope under general anesthesia in the operating room. Intergroup differences were compared with Mann-Whitney U test, two-tailed Chi-square test was used for group frequency and Fisher's Exact test for group items less than five. A P value of 0.05 was considered to indicate statistical significance Results: Cases consisted of 21 males (56,8%) and 16 (43,2%) females. Eighteen cases with chronic cough and nineteen cases with recurrent pneumonia were followed up. A foreign body was determined in twelve (32,4%) cases with rigid bronchoscopy. Foreign body diagnosis was detected significantly more frequently in recurrent pneumonia cases than in chronic cough cases (p< 0,0012). Conclusion: Bronchoscopy is valuable in diagnosing and treating children not responding to medical therapy with chronic cough and recurrent pneumonia.