MEDIASTINAL CASTLEMAN'S DISEASE: REPORT OF TWO CASES AND REVIEW OF THE LITERATURE

Castleman hastalığı, yaş ve cinsiyetten bağımsız olarak görülen lenf nodlarının aşırı büyümesidir. Kliniğimizde cerrahi olarak tedavi edilen ve histopatolojik inceleme sonunda Castleman hastalığı tanısı alan 37 yaşında kadın ve 38 yaşında erkek olgular tartışılmaktadır. Her iki hastaya da tanısal torakotomi yapılarak kitleler rezeke edilmiş ve patoloji sonuçları hyaline-vasküler tipte Castleman hastalığı olarak bildirilmiştir. Olgular halen takip altında ve asemptomatiktirler. Castleman's disease is an enlargement of lymph nodes without differentiaton of age and sex. A 37-year-old woman and a 38-year-old man patients were treated surgically in our clinic who were diagnosed as Castleman's disease with histopathological examination. For both of the patients diagnostic thoracotomy was performed and tumoral masses were resected. Postoperatively, hyaline-vascularized type Castleman's disease was diagnosed and our patients were remained asymptomatic at follow-up. Our patients were remained asymptomatic for follow-up after operation

Effects of ozone therapy on the development of contralateral lung in rats that underwent left pneumonectomy

Amaç: Pnömonektomi göğüs cerrahisinin en major ameliyatlarından biri olup artan akciğer kanseri oranları nedeniyle sıkça uygulanmaktadır. Pnömonektomi sonrası kısıtlanan solunum rezervi hasta hayat kalitesini düşüren postoperatif günlük aktivitelere geri dönüş zamanını, hastanede kalış süresini uzatan ve bakım masraflarını arttıran en önemli etkendir. Pnömonektomi sonrası kontrlateral akciğerde volüm, ağırlık, kollajen içeriği, protein ve hücre boyutları artar. Bu durum operasyon öncesi sınırlı solunum rezervine sahip olan hastalar için önemlidir. Rezidü akciğerde boyutsal artış sağlanması solunum fonksiyonlarının düzelmesine katkıda bulunacaktır. Bu amaçla kullanılan bir çok ajanın çok azında olumlu sonuç alınmıştır. Kısıtlı olmakla beraber yapılan çalışmalardan yola çıkarak pnömonektomi yapılmış ratlarda operasyon öncesi ve sonrası rektal yolla uygulancak ozon terapinin kalan akciğer dokusu üzerine etkilerini araştırmak amaçlanmıştır. Gereç ve Yöntem: Bu çalışmada aynı koloniden 21 adet yetişkin, erkek Wistar albino rat kullanılmıştır. Ratlar üç gruba bölünerek vücut ağırlıkları ölçülmüştür (A, B, C,). Grup A, sham grubudur ve sadece posterolateral sol torakotomi yapılmıştır. Grup B ve C'ye posterolateral sol torakotomiyi takiben 4-0 ipek sütür ile hiler yapılar bağlanıp sol pnömonektomi yapılmıştır. Ozon terapi uygulanan tek grup C grubu olup operasyon öncesi 5 gün boyunca hergün 10 µgr/ml ozon 0.36mg/kg dozda, operasyon sonrası 5 gün boyunca hergün 30 µgr/ml ozon 1.1mg/kg dozda intrarektal yoldan uygulanmıştır. Ameliyattan 7 gün sonra ratlar letal dozda ketamin kullanılarak sakrifiye edilip total vücut ağırlıkları ölçülmüş ve sağ akciğer trakea ile birlikte çıkarıldıktan sonra akciğer ağırlığı ölçülmüştür. Akciğer ağırlığı ve volümü sakrifikasyon öncesi vücut ağırlığı ile ayrı ayrı oranlanmış; akciğer ağırlık indeksi ve akciğer volüm indeksi bulunmuştur. Akciğer dokuları histopatolojik olarak incelenmiştir. Sonuçlar istatistiksel olarak değerlendirilmiştir. Objective: Pneumonectomy is one of the major surgeries of thoracic surgery and has become frequently used due to the increasing rate of lung cancers. Restricted respiration reserve after pneumonectomy is the most important factor that decreases patient?s life quality, extends hospital stay, time of returning back to daily activities and healthcare costs. Volume, weight, collagen content, protein and cellular size of contralateral lung increase after pneumonectomy. This situation is important for patients with preoperatively restricted respiratory reserve. Provision of size increase in residual lung shall contribute to improvement of respiratory functions. Few from many of the agents used for this purpose yielded positive results. In this study it is amied to investigate the effects of rectally administered preoperative and postoperative ozone therapy in rats to increase the development of the residual lung tissue. Material and Method: In this study, 21 adult, male Wistar albinor rats of the same colony were used. Rats were divided into three groups and the body weights were measured (A, B, C). Group A is the sham group and underwent only posterolateral left thoracotomy. Group B and C underwent left pneumonectomy after ligation of hilar structures with 4-0 silk-suture following posterolateral and left thoracotomy. C group is the only group that received ozone therapy every day for 5 days preoperatively in 10 µgr/ml, 0.36mg/kg doses and every day for 5 days postoperatively in 30 µgr/ml, 1.1mg/kg doses. Rats were sacrificed 7 days after surgery with ketamine of lethal doses and their total body weights were measured, right lung were extracted with trachea and the right lung weights were measured.. The pulmonary tissues were histologically examined. The lung volume and weight before sacrificing were proportioned with body weight and lung weight and volume indexes were found. The results were statistically assessed

Evaluation of Quality of Life After Bilateral Endoscopic Thoracic Sympathectomy for Primary Hyperhidrosis

WOS: 000284097600010Background. Primary hyperhidrosis is a disorder from which 1% of the society suffers. Objectives. This present study is aimed to evaluate the effects of endoscopic thoracic sympathectomy on the primary hyperhidrosis. Material and Methods. Between February 2008 and April 2010, 30 patients with primary hyperhidrosis underwent endoscopic thoracoscopic sympathectomy. Before the operation, 4 (13.3%) cases had sweating on scalp with flushing on the forehead. There was primary palmar hyperhidrosis in 25 (83.3%) cases, facial hyperhidrosis in 17 (56.6%) cases and primary plantar hyperhidrosis in 19 (63.3%) cases. The second and the third thoracic sympathetic ganglia were bilaterally cauterized in 6 (20.0%) of the cases, while 2(nd), 3(rd) and 4(th) thoracic sympathetic ganglia were bilaterally cauterized in 24 (80.0%) cases. Results. Quality of life was evaluated by Hyperhidrosis Disease Severity Scale in preoperative and postoperative period. Before the operation, 10 (33.3%) cases expressed that hyperhidrosis was barely tolerable followed by 20 (66.7%) cases expressing that hyperhidrosis was intolerable. After the operation, compensatory sweating was never noticeable in 8 (26.6%) cases, tolerable in 15 (50.0%) cases, barely tolerable in 5 (16.7%) cases, intolerable in 2 (6.6%) cases. In order to assess the quality of life before and after the operation, a scale between 1 (very poor) and 10 (very good) has been implemented. It was found that average before the operation was 7 (2-8), while average after the operation was 8.2 (6-10) (P < 0.001). Conclusions. Endoscopic thoracic sympathectomy is most efficient treatment method of primary hyperhidrosis for enhancing the quality of life (Adv Clin Exp Med 2010, 19, 5, 619-624)