The evaluation of Pat-Pat related injuries in the western black sea region of Turkey

BACKGROUND: Accidents caused by motorized vehicle in the agricultural sector are frequently observed. In Turkey; accidents arising from motorized vehicles, named Pat-Pat, which are used by farmers in the Western Black Sea region is not unusual. METHODS: One hundred five patients who were brought into the Emergency Department of Duzce University, Medical Faculty Hospital between September 2009 and August 2010 due to Pat-Pat related accidents were evaluated. RESULTS: The cases consisted of 73 (69.5%) males and 32 (30.5%) females, ranging from 2 to 73 years of age. In the 10-39 age group, a total of 63 (60.0%) cases were determined. The months when the greatest rate of cases applied to the hospital consisted of July, August, September and the season is summer. The cases were exposed to trauma in roads in 54 (51.4%), and 51 (48.6%) occurred in agricultural area without roads. Eighty seven (82.9%) cases were injured due to the overturning of vehicle. The patients were brought to the hospital using a private vehicle in 54 (51.4%) of the cases and in 51 (48.6%) cases, 112 ambulance system was used. The cases were determined to apply to the hospital most frequently between 6 pm-12 am. The injuries frequently consisted of head-neck and spine traumas, thorax traumas and upper extremity traumas. In 55 (52.4%) cases, open wound-laceration was determined. Seventy five (71.4%) cases were treated in the Emergency Department, and 28 (26.7%) were hospitalized. Three (2.9%) cases were deceased. CONCLUSIONS: Serious injuries can occur in Pat-Pat related accidents, and careful systematic physical examination should be conducted. In order to prevent these accidents, education of farm operators and engineering studies on the mechanics and safety of these vehicles should be taken and legal regulations should be created

The effects of erdosteine on experimental acute pancreatitis model

YÖK Tez No: 319234ÖZETAkut pankreatit kendi kendini sınırlayan hafif semptomlardan multiorgan yetmezliği ile seyreden fulminant gidişe kadar oldukça geniş klinik sunum gösterebilen bir hastalıktır.Bu çalışmada 30 adet erkek Wistar albino rat her birinde 10 adet olacak şekilde 3 gruba ayrılmıştır. Grup 1'de herhangi bir işlem yapılmamıştır. Grup 2 ve Grup 3' teki ratlara birer saat ara ile 6 kez toplam 80 ?g/kg olacak şekilde subkutan cerulein enjekte edilerek deneysel pankreatit modeli oluşturulmuş ve bu durumun teyidi için kan amilaz ve lipaz değerlerine bakılmıştır. Grup 3'teki ratlara 10 mg/kg Erdostein orogastrik yol ile verilmiştir. Bu tedaviye 2 gün daha devam edilmiş ve ratlar 3. gün sakrifiye edilmiştir. Ratlardan çıkarılan pankreas dokusunda ödem, inflamasyon, yağ nekrozu, asiner nekroz ve vakuolizasyon histopatolojik olarak araştırılmış ve 0 ile 4 arasında skorlar verilerek değerlendirme yapılmıştır.Cerulein kullanımıyla amilaz ve lipaz gibi biyokimyasal tetkiklerin sonuçları ve pankreas dokularının histopatolojik olarak incelenmesi sonucunda ratlarda akut pankreatit gelişmiş ve pankreas dokusunda ciddi boyutlarda ödem, inflamasyon, asiner nekroz, yağ nekrozu ve vakuolizasyon gözlenmiştir. Grup 3'teki ratlarda Erdosteinin beklenilen antiinflamatuar etkisi elde edilmiş ve oluşan pankreatit şiddetinin azaldığı histopatolojik olarak gösterilmiştir. Çalışmanın istatistiksel sonuçları incelendiğinde ise Erdosteinin akut pankreatit dokusunda inflamasyon, asiner nekroz, yağ nekrozu ve vakuolizasyon skorlarında anlamlı azalmalara yol açtığı ortaya çıkmıştır.Sonuç olarak Cerulein ile ratlarda ağır pankreatit oluşturulmuş ve Erdostein kullanımı ile pankreatit şiddeti azalmış olarak bulunmuştur. Erdostein ile elde ettiğimiz bu olumlu sonuçlar daha kapsamlı deneysel ve klinik çalışmalar ile desteklenebildiği takdirde Erdostein akut pankreatit tedavisinde olumlu etkileri olan yeni bir tedavi yöntemi olarak kullanılabilecektir.ABSTRACTAcute pancreatitis is a disease which can manifest itself with a wide range of clinical presentations from self-limiting mild symptoms to fulminant course with multiorgan failure.In this study, 30 male Wistar albino rats were divided into 3 groups, with 10 rats in each group. No action was taken in Group 1. An experimental pancreatitis model was formed with the rats in Groups 2 and 3, which were given subcutaneous cerulean injection of 80 ?g/kg in total administered in 6 doses every one hour, and blood amylase and lipase values were assessed for confirmation. Erdosteine 10 mg/kg was administered via orogastric route in the rats in Group 3. This treatment was continued for another 2 days and the rats were sacrificed on the 3rd day. The pancreas tissues removed from the rats were examined histopathologically for edema, inflammation, fat necrosis, acinar necrosis and vacuolization, and the evaluation was made by scoring between 0 and 4.At the end of the biochemical examination of amylase and lipase values and the histopathological examination of pancreas tissues, it was concluded that the rats developed acute pacreastitis by cerulean use, and serious edema, inflammation, acinar necrosis, fat necrosis and vacuolization were observed in the pancreas tissue. In the rats in Group 3, Erdosteine had the expected anti-inflammatory effect, and the histopathological results showed a reduction in pancreatitis severity. According to the statistical results of the study, Erdosteine resulted in significant reductions in the inflammation, acinar necrosis, fat necrosis and vacuolization scores in acute pancreatitis tissues.Consequently, severe pancreatitis was created by cerulein in the rats, and pancreatitis severity was reduced by the use of Erdosteine. If these favorable results obtained by Erdosteine are supported by more comprehensive experimental and clinical studies, Erdosteine can be used as a new treatment method with favorable effects in the treatment of acute pancreatitis

Effects of Erdosteine on Experimental Acute Pancreatitis Model

WOS: 000416737000004PubMed: 29056120Objective: To create acute pancreatitis condition experimentally in rats using cerulein, and to reveal histopathological effects in pancreatic tissue with erdosteine. Study Design: An experimental study. Place and Duration of Study: Department of General Surgery, Duzce University, Turkey, from June to October 2014. Methodology: Thirty male Wistar albino rats were divided into three groups. No procedures were applied to Group 1. The rats in Group 2 and Group 3 were injected cerulein, to establish an experimental pancreatitis model and the blood amylase and lipase values were examined. The rats in Group 3 were given 10 mg/kg erdosteine. This treatment was continued for another 2 days and the rats were sacrificed. The pancreatic tissues were examined histopathologically for edema, inflammation, acinar necrosis, fat necrosis, and vacuolization. Results: The lipase and amylase values and the histopathological examination of pancreatic tissues evidenced that the experimental acute pancreatitis model was established and edema, inflammation, acinar necrosis, fat necrosis, and vacuolization were observed in the pancreatic tissues. The statistical results suggest that erdosteine can decrease the edema, inflammation, acinar necrosis, fat necrosis and vacuolization scores in the tissues. Conclusion: The severity of acute pancreatitis, induced by cerulein in rats, is reduced with the use of erdosteine

A Rare Cause of Abdominal Pain: Scar Endometriosis

Introduction. Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section. There have been instances of women presenting to emergency or general surgery clinics with abdominal pain due to SE. Materials and Methods. This study retrospectively reviews 19 patients who were operated on in our clinic between January 2010 and January 2017 with a prediagnosis of SE and were reported to have SE based on their pathology results. Results. The mean age of the patients was 30.8 years (range: 20-49 years). The body mass indexes of 12 (63.2%) patients were ≥ 25. All patients had a history of cesarean section and 9 (47.4%) patients had undergone cesarean section once. With the exception of one patient who had her SE localized in her inguinal region, all patients had a mass localized on their anterior abdominal wall neighboring the incision and complained about cyclic pain starting in their premenstrual periods. The complaints began 2 years after their cesarean section in 10 (52.6%) patients. Mostly abdominal ultrasonography was used for diagnostic purposes. The lesions were totally excised and the SE diagnosis was made through a histopathological examination in all patients. No postoperative complications or recurrences were seen in any of the patients. Conclusion. Suspicion of SE is essential in women of reproductive age who have a history of cesarean section and complaints of an anterior abdominal wall mass and a pain at the scar site that is associated with their menstrual cycle. An accurate and early diagnosis can be established in such patients through a careful history and a good physical examination and possible morbidities can be prevented with an appropriate surgical intervention

The histopathological evaluation of mediastinal lymph node stations in sarcoidosis

WOS: 000304300200006Background: Even if the clinical and radiological findings indicate sarcoidosis, diagnosis can be established by showing histopathologically the sarcoid granulomas in the tissue. Mediastinoscopy is a surgical procedure that is commonly used to obtain histological specimens to examine for mediastinal lymph node involvement in sarcoidosis. Objective: To demonstrate which of the mediastinal lymph node stations that the biopsies were taken had the highest diagnostic value for histopathological examination in sarcoidosis. Methods: Operative and histopathology reports of 14 patients who underwent mediastinoscopy and diagnosed with sarcoidosis in the Thoracic Surgery Clinic of Duzce University School of Medicine, between January 2009 and January 2011 were reviewed retrospectively. Results: On thorax tomography images of the patients with sarcoidosis, lymph nodes of the bilateral lower paratracheal and hilar mediastinal lymph node stations were frequently enlarged to pathological dimensions. In the majority of the cases, biopsies were taken by mediastinoscopy from the bilateral lower paratracheal lymph node stations. Histopathological examination of the biopsy material showed severe noncaseating granulomatous inflammation, most commonly in the right lower paratracheal, followed by left lower paratracheal and at least common highest mediastinal lymph node stations. Conclusions: During mediastinoscopy to be performed on patients with suspected sarcoidosis, we recommend that priority be given to taking biopsies from the lower paratracheal lymph nodes and sent for frozen examination for definitive diagnosis to prevent unnecessary mediastinal dissection that might result in serious complications

Primary Hydatid Cyst of the Chest Wall

WOS: 000308968400015PubMed: 22249910

Bilaterally recurrent spontaneous pneumothorax due to lymphangioleiomyomatosis

Pulmoner lenfanjiyoleiomyomatozis oldukça nadir görülen bir interstisyel akciğer hastalığıdır. Klinik tablo genellikle nüks spontan pnömotoraks ve progresif dispne şeklindedir. Kesin bir tedavi seçeneği olmamakla birlikte, yıllar içerisinde akciğer parankiminde oluşan multikistik destrüksiyonla solunum yetmezliğine neden olmaktadır. Otuz dokuz yaşında kadın hasta ani başlayan nefes darlığı ve yaygın göğüs ağrısı yakınmaları ile kliniğimize başvurdu. Oskültasyonda her iki akciğerde solunum seslerinde azalma tespit edildi. Akciğer grafisinde iki taraflı pnömotoraks gözlenmesi üzerine iki taraflı tüp torakostomi uygulandı. Toraks tomografisinde sağda daha fazla olmak üzere her iki akciğerde yerleşmiş birkaç ince duvarlı kistik yapı tespit edildi. Hastaya sağ posterolateral torakotomi ile büllektomi, apikal kama rezeksiyonu, apikal parietal plörektomi ve geri kalan plevral alanlara mekanik plevral abrazyon yapıldı. Hastada bir ay sonra oluşan sol nüks pnömotoraks nedeni ile sol posterolateral torakotomi ile büllektomi, bül ligasyonu, apikal kama rezeksiyonu, apikal parietal plörektomi ve geri kalan plevral alanlara mekanik plevral abrazyon uygulandı. Histopatolojik inceleme ile hastaya lenfanjiyoleiomyomatozis tanısı konuldu. İki yıllık takip süresinin sonunda pnömotoraks nüksü gözlenmedi. İki taraflı nüks spontan pnömotoraks gelişen premenopozal kadınlarda lenfanjiyoleiomyomatozis mutlaka akılda tutulmalıdır. Bu hastalarda konservatif yöntemlerle pnömotoraksın sıklık ile nüks etmesi nedeni ile erken dönemde cerrahi tedavi yapılmalıdır.Pulmonary lymphangioleiomyomatosis is an extremely rare interstitial lung disease. The clinical presentation is generally recurrent spontaneous pneumothorax and progressive dyspnea. No definitive treatment option is available and it leads to respiratory failure due to multicystic destruction of the lung parenchyma in the following years. A 39-year- old female patient was admitted to our clinic with the complaints of sudden onset dyspnea and diffuse chest pain. Auscultation revealed decreased respiratory sounds in both lungs. Chest X-ray showed bilateral pneumothorax and bilaterally tube thoracostomy was performed. Thoracic tomography demonstrated a few thin-wall cystic structures in both lungs with a higher number on the right side. We performed bullectomy, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through right posterolateral thoracotomy. One month later, we performed bullectomy, bulla ligation, apical wedge resection, apical parietal pleurectomy and mechanic pleural abrasion on residual pleural spaces through left posterolateral thoracotomy due to the left recurrent pneumothorax. The patient was diagnosed with lymphangioleiomyomatosis based on the histopathological examination. No recurrent pneumothorax was observed at the end of the two-year follow- up period. Lymphangioleiomyomatosis should be kept in mind in premenopausal women who have bilaterally recurrent spontaneous pneumothorax. Early surgical treatment should be planned in these patients due to multiple pneumothorax recurrences with conservative procedures

The Effects of Erdosteine on Tracheal Healing in Rats

Kandis, Hayati/0000-0001-9151-6050WOS: 000290428500004Background. Proliferating scar tissue and strictures, which are still serious problems of tracheal surgery, are caused by an inflammatory reaction with subsequent edema and granulation tissue. Tracheal stenosis leads to severe morbidity and multiple surgical operations are sometimes needed in those patients. Objectives. To assess the effect of the antioxidant and anti-inflammatory drug Erdosteine to prevent tracheal stenosis in a rat model. Material and Methods. Fourteen female adult Wistar albino rats were divided into two groups, a control group (Group A, n = 7) and an Erdosteine group (Group B, n = 7). Under general anesthesia, the tracheas were incised vertically, extending from the 3(rd) to the 5(th) cartilaginous rings and closed primarily with absorbable sutures. Group A had 0.5 cc/day 0.9% NaCl, and Group B had 10 mg/kg/day Erdosteine, both administered by gavages and maintained for 10 days. At the end of the procedure, the rats were sacrificed and their tracheas were excised from cricoid cartilage to carina. The specimens were histologically evaluated using light microscopy and scored for inflammatory cell infiltration, angiogenesis, fibroblast proliferation, collagen deposition, and epithelial regeneration. All of the results were statistically analyzed and a value of p < 0.05 was considered statistically significant. Results. There were only meaningful differences in epithelial regeneration (p = 0.001), displaying that epithelial regeneration was better in Group B. However, the differences in inflammatory cell infiltration, angiogenesis, fibroblast proliferation and collagen deposition did not reach statistical significance. Conclusions. The severity of pathological changes forming in the tissue after tracheal surgery could not be reduced with Erdosteine use. Thus, Erdosteine does not seem to be an applicable preventive treatment agent for possible postsurgical tracheal stenosis (Adv Clin Exp Med 2011, 20, 1, 31-37)

Incidental Papillary Thyroid Microcarcinoma in an Endemic Goiter Area

Clinical and pathological characteristics of incidental papillary thyroid microcancer cases, surgical, medical, and nuclear treatment methods, and patients’ outcome were studied during follow-up period of 102 months. We studied 37 patients with incidental papillary thyroid microcancer (I-PTM). The surgical procedure was total thyroidectomy in 29 and hemithyroidectomy in 8 patients. Size, multifocality, and bilateralism of PTM foci, thyroid capsule invasion, and presence of lymphovascular invasion were histopathological parameters. We analysed adjuvant medical and nuclear treatment and patients’ outcome during follow-up period of 102 (61–144) months. The prevalence rates of I-PTM were 9.4% in 395 thyroidectomy cases. Histopathological examination reported unifocal disease in 30 and multifocal disease in 7 (18%) patients. Multifocal disease was bilateral in 6 (20.1%) patients. The mean size of the PTM foci was 4.88 mm. The rate of thyroid capsule invasion was 5.4%. All patients received a suppressive dose of LT4 to achieve a low serum TSH level. Adjuvant surgical and nuclear treatment was not performed in our cases. We did not find any negative changes in blood chemistry and ultrasound imaging, and any unfavourable events as locoregional and systemic recurrence. In conclusion, diagnosis of I-PTM is common that multifocality and bilateralism appear as pathologic features. The prognosis is excellent after surgical treatment and TSH suppression. Routine adjuvant nuclear treatment is unnecessary in majority of patients