Inhalation Injury

Inhalation injury is defined as airway or pulmonary parenchymal injury caused by inhalation of smoke, toxin and chemical gases. Frequently, it results from inhalation of smoke and incomplete products of combustion. The mortality and morbidity of burn patients increase with the damaging effect of inhalation injury. Lung injury from smoke inhalation can be caused by chemical and thermal insults. In the early period, the upper airway obstruction may develop due to chemical or direct thermal injury. Pathophysiological changes in the lung associated with inhalation injury result from inhalation of incomplete products of combustion. Pulmonary oedema, hypoxia, ventilation-perfusion mismatching, increased airway resistance, decreased pulmonary compliance, increased pulmonary vascular resistance, and atelectasis occur due to inhalation injury. The risk of infection (pneumonia) is increased and consequently, acute respiratory disease syndrome (ARDS) may occur. Some clinical symptoms and signs are suggestive and fiberoptic bronchoscopy may be diagnostic. For treatment, sufficient oxygenation and patency of airway must be provided. Therapeutic coughing, chest physiotherapy, airway suctioning with nasotracheal aspiration or bronchoscopy have been effective in the removal of retained secretions. Medical treatment includes administration of bronchodilators, racemic epinephrine, mucolytics and analgesic drugs. Another important issue is sufficient fluid resuscitation. In conclusion, the objective of the management is maintaining the respiratory care and thus the morbidity and mortality associated with inhalation injury can be reduced

MUC4 expression and its relation to ErbB2 expression, apoptosis, proliferation, differentiation, and tumor stage in non-small cell lung cancer (NSCLC)

There is a peptide sequence homology between the gene product of human MUC4 and rat Muc4/sialomucin complex (SMC). Each contains a transmembrane subunit with two epidermal growth factor (EGF)-like domains that act as ligand for ErbB2. MUC4 and ErbB2 mediate intracellular signaling pathways that are linked to repression of apoptosis and either to proliferation or to differentiation of tumor cells. This study investigates the expression of human MUC4 in neoplastic and corresponding non-neoplastic tissues, and the relation of MUC4 expression in neoplastic tissues to ErbB2 expression, apoptosis, proliferation, differentiation, and tumor stage in a series of 100 non-small cell lung carcinomas (NSCLCs). MUC4 and ErbB2 expressions and cell proliferation (PCNA) were shown using immunohistochemistry. Apoptotic index (AI) and tumor differentiation were determined by morphologic criteria. All the non-neoplastic bronchial tissues and 85% of NSCLCs showed MUC4 expression. MUC4 expression was found to be higher in neoplastic than in non-neoplastic tissues (Yates correction p: 0.0006). MUC4 expression was inversely correlated with Al (p = 0.0002) and was correlated with ErbB2 expression (p = 0.022), but not with PCNA counts and tumor stage. Our results indirectly suggest that MUC4, in association with ErbB-2, might be involved in the repression of apoptosis and differentiation rather than proliferation in tumor cells of NSCLCs. (c) 2006 Elsevier GmbH. All rights reserved

Surgical and survival outcomes of sleeve lobectomy after neoadjuvant theraphy in lung cancer: With group of 265 patients

[Abstract Not Available

Capitonnage Results in Low Postoperative Morbidity in the Surgical Treatment of Pulmonary Echinococcosis

Background. The main surgical techniques in the treatment of pulmonary echinococcosis are cystotomy alone, cystotomy and capitonnage, enucleation, and pericystectomy. Controversy persists regarding the selection of surgical technique. We reviewed our experience to identify the impact of capitonnage on outcomes

Iterative surgical resections in non-small cell lung carcinoma

[Abstract Not Available

Video-assisted thoracoscopic lobectomy and bilobectomy versus open thoracotomy for non-small cell lung cancer: Mortality and survival

Background: In this study, we aimed to evaluate patients who had non-small cell lung cancer and underwent resection, to investigate our tendency to prefer video-assisted thoracic surgery or open thoracotomy, and to compare 30-and 90-day mortalities and survival rates. Methods: Between January 2013 and January 2019, a total of 706 patients (577 males, 129 females; mean age: 61.9 +/- 8.6 years; range, 17 to 84 years) who underwent lobectomy or bilobectomy due to primary non-small cell lung cancer were retrospectively analyzed. The patients were divided into two groups as operated on through video-assisted thoracic surgery and through open thoracotomy. The 30-and 90-day mortality rates and survival rates were compared. Results: Of the patients, 202 (28.6%) underwent video-assisted thoracic surgery and 504 (71.4%) underwent open thoracotomy. Lobectomy was performed in 632 patients (89.5%) and bilobectomy was performed in 74 patients (10.5%). Patients who were chosen for video-assisted thoracic surgery were statistically significantly older, did not require any procedure other than lobectomy, did not receive neoadjuvant therapy, had a small tumor, and did not have lymph node metastases. The 30-and 90-day mortality rates in the video-assisted thoracic surgery and open thoracotomy groups were 1.8% vs. 2% and 2.6% vs. 2.5%, respectively. The five-year survival rates of video-assisted thoracic surgery and open thoracotomy groups were 74.1% and 65.2%, respectively (p>0.05). The 30-and 90-day mortality and five-year survival rates were 2.1%, 2.6%, and 73.5% in the video-assisted thoracic surgery group and 2.1%, 2.1%, and 68.5% in the open thoracotomy group, respectively, indicating no statistically significant difference between the two groups. Conclusion: Throughout the study period, video-assisted thoracic surgery was more preferred in patients with advanced age, in those who had a small tumor, who did not receive neoadjuvant therapy, did not have lymph node metastasis, and did not require any procedure other than lobectomy. In the video-assisted thoracic surgery and open thoracotomy groups, 30-and 90-day mortality and five-year survival rates were similar. Based on these findings, both procedures seem to be acceptable in this patient population

Chest wall resection for lung cancer: A 12-year experience in a single center

[Abstract Not Available