1
|
Beyoglu MA, Sahin MF, Turkkan S, Turhan N, Demirag F, Yekeler E. An Unusual Diagnosis in a Single-Lung Transplant Recipient: Secondary Amyloidosis. EXP CLIN TRANSPLANT 2024; 22:246-248. [PMID: 36259624 DOI: 10.6002/ect.2022.0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Silicosis, a progressive, fibrotic occupational lung disease with no known treatment, is an uncommon indication for lung transplant. There is a paucity of research on patients with silicosis who have received lung transplants. The long-term consequences of the native lung in patients with severe chronic silicosis who have had a single-lung transplant are also of interest. We present a case of amyloidosis in a patient who underwent a single-lung transplant for silicosis.
Collapse
Affiliation(s)
- Muhammet Ali Beyoglu
- From the Department of General Thoracic Surgery and Lung Transplantation Ankara City Hospital, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
2
|
Ciflik KB, Beyoglu MA, Sahin MF, Mutlu SC, Yüce BRH, Yekeler E, Koçer B, Karaoglanoglu N. Analysis of thoracic trauma patients transferred to Türkiye's largest hospital after Kahramanmaraş earthquake. ULUS TRAVMA ACIL CER 2024; 30:33-37. [PMID: 38226568 DOI: 10.14744/tjtes.2023.00748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024]
Abstract
BACKGROUND On February 6, 2023, an earthquake in Türkiye caused massive destruction. Over 50.000 people are known to have lost their lives, and over 100.000 are known to have been maimed. In our study, we aimed to analyze the treatment process of 267 METHODS: The demographic characteristics, the time spent under the rubble, the duration of transfer to the hospital, and the treatment process of patients admitted to our hospital have been evaluated. RESULTS There are 125 (46.8%) men and 142 (53.2%) women in the study. The rate of thoracic trauma was 21.8%. Of all the patients, 15.7% (n=42) had pneumothorax, 18% (n=48) had contusion, 28.8% (n=77) had hemothorax, and 73% (n=195) had rib fractures. The mean time spent under the rubble was 17.6±26.5 h, the duration of transfer to the hospital was 138.5±113.6 h, and the hospitalization time was 93.8±152.3 h. The duration of hospitalization and transfer has been statistically longer for the patients who were under the rubble (85.4%) than for those who were not. (14.6%) (p=0.048). There is a statistically weak positive correlation between the time spent under the rubble and the time of transfer (p=0.048). CONCLUSION The state, the time spent under the rubble, and the presence of hemothorax and pneumothorax should be effectively evaluated in earthquake-induced thoracic traumas. Considering these criteria in the transfer of patients to the centers operating at full capacity in a short time will minimize morbidity and mortality.
Collapse
Affiliation(s)
- Kadir Baturhan Ciflik
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Muhammet Ali Beyoglu
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Mehmet Furkan Sahin
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Sabri Can Mutlu
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Behaeddin Raşid Han Yüce
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Erdal Yekeler
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Bülent Koçer
- Department of Thoracic Surgery, University of Healt Sciences Ankara City Hospital, Ankara-Türkiye
| | - Nurettin Karaoglanoglu
- Department of Thoracic Surgery, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara-Türkiye
| |
Collapse
|
3
|
Ciflik KB, Dogan HT, Dogan E, Ciflik BO, Kocer B, Karaoglanoglu N, Yekeler E. Can tumour budding change the future of pulmonary adenocarcinoma? Pathol Res Pract 2023; 250:154808. [PMID: 37748210 DOI: 10.1016/j.prp.2023.154808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 08/24/2023] [Accepted: 09/07/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND Pulmonary adenocarcinoma shows different prognosis even in the same pathological subtype and stage. In this study, it is aimed to investigate the relationship between tumour budding and known prognostic values and clinicopathological features in pulmonary adenocarcinoma. METHODS In this study, there have been 77 patients diagnosed with primary pulmonary adenocarcinoma. In the evaluation process, the number of budding between 0 and 4 is accepted as low budding (Bd1), the number of budding between 5 and 9 is considered as medium budding (Bd2), and the number of budding above 10 is considered as high budding (Bd3). RESULTS According to the findings of the study, it can be seen that there is a statistical difference between tumour budding and stromal fibrosis (p < 0.001). The presence of pleural invasion, lymph vascular invasion and perineural invasion in patients with Bd3 is found to be statistically higher than the patients with Bd1 (p = 0.048) (p = 0.041) (p = 0.029). CONCLUSIONS Tumour budding has been associated with pleural invasion, lymph vascular invasion, perineural invasion, and stromal fibrosis. This study is the first to show the relationship between tumour budding and stromal fibrosis in pulmonary adenocarcinomas. The role of tumour budding in lung cancers remains to be clarified.
Collapse
Affiliation(s)
| | - Hayriye Tatli Dogan
- Department of Pathology, Ankara Yildirim Beyazit University, Ankara, Turkey.
| | - Elif Dogan
- Department of Pathology, Ankara City Hospital, Ankara, Turkey.
| | | | - Bulent Kocer
- Department of Thoracic Surgery, Ankara City Hospital, Ankara, Turkey.
| | | | - Erdal Yekeler
- Department of Thoracic Surgery, Ankara City Hospital, Ankara, Turkey.
| |
Collapse
|
4
|
Beyoglu MA, Sahin MF, Turkkan S, Yazicioglu A, Akbulut ED, Neselioglu S, Erel O, Yekeler E. Dynamic Thiol-Disulfide Homeostasis in Lung Transplant Recipients. EXP CLIN TRANSPLANT 2023; 21:841-847. [PMID: 34981712 DOI: 10.6002/ect.2021.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES In this study, we investigated dynamic thiol-disulfide homeostasis as a new indicator of oxidative stress in lung transplant recipients. In addition, we compared dynamic thiol-disulfide homeostasis parameters according to transplant indication and time after transplant. MATERIALS AND METHODS This study had a single-center, observational, randomized design. In terms of transplant indications, lung transplant recipients were grouped as chronic obstructive pulmonary disease, interstitial lung disease, bronchiectasis, and other indications. To make comparisons based on time after transplant, lung transplant recipients were categorized into the following groups: >6 and ≤24 months, >24 and ≤48 months, >48 and ≤72 months, and >72 months. A fully automated spectrophotometric technique was used to measure dynamic thiol-disulfide homeostasis in fasting blood samples. RESULTS Our study included 34 lung transplant recipients and 36 healthy volunteers. Native thiol (P = .005) and total thiol levels (P = .06) were lower in lung transplant recipients. Disulfide levels were similar. Disulfide-to-native thiol (P = .027) and disulfide-to-total thiol ratios (P = .027) were significantly higher in lung transplant recipients. Native thiol-to-total thiol ratios were lower in lung transplant recipients (P = .027). When we examined patients according to transplant indication, no statistically significant differences were found in dynamic thiol-disulfide homeostasis parameters, except for total thiol and disulfide levels. We also found no significant differences when we examined dynamic thiol-disulfide homeostasis parameters according to time after transplant. CONCLUSIONS Thiol-related antioxidant activity is significantly reduced after lung transplant, regardless of indication and transplant time. Ensuring oxidative balance in lung transplant recipients with an antioxidant supplement regimen can prevent damage from oxidative stress.
Collapse
Affiliation(s)
- Muhammet Ali Beyoglu
- From the Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Türkkan S, Çelik Başaran F, Şahin MF, Beyoğlu MA, Bindal M, Yazıcıoğlu A, Yekeler E. Outcomes of lung transplantation for chronic obstructive pulmonary disease. Tuberk Toraks 2023; 71:215-223. [PMID: 37740625 PMCID: PMC10795245 DOI: 10.5578/tt.20239703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
Introduction Chronic obstructive pulmonary disease is a progressive airway disease that can progress to the terminal stage requiring oxygen supply. In this period, lung volume reduction therapies and/or lung transplantation may be considered. Morbidity and mortality risks due to transplant surgery and posttransplant immunosuppressive therapy show the importance of selecting the best candidates who will benefit from transplantation. In this context, BODE index criteria serve as important markers. This study aimed to analyze the outcomes of lung transplantation in patients with chronic obstructive pulmonary disease and to identify variables that may affect post-transplant clinical outcomes. Materials and Methods Lung transplants diagnosed with chronic obstructive pulmonary disease performed in our center between March 2013 and January 2023 were included in the study. Demographic information and both pre-op and post-op clinical data of the transplant patients were collected. The effect of BODE index criteria and other pre-transplant clinical data on short- and long-term outcomes after transplantation were investigated. Results During the study period, 34 lung transplants were performed for chronic obstructive pulmonary disease. One patient died during the operation, three patients received single transplants, and 30 received double transplants. Post-operative primary graft dysfunction was more common in single transplant recipients. The results were comparable between single and double transplants in terms of post-transplant pulmonary function and the development of chronic lung allograft dysfunction. BODE index criteria had no effect on early and late post-operative clinical data, however intra-operative use of extracorporeal membrane oxygenation, primary graft dysfunction, and prolonged extubation were significantly higher in recipients younger than 60 years. Conclusion Our study suggests that prelisting demographic and clinical data of chronic obstructive pulmonary disease patients had no significant effect on post-operative outcomes, however, intra-operative ECMO use, prolonged extubation, primary graft dysfunction (p< 0.05 for each) and chronic rejection (p> 0.05) were more common in patients who are <60 years of age. These data need to be confirmed by larger studies.
Collapse
Affiliation(s)
- Sinan Türkkan
- Clinic of Thoracic Surgery and Lung Transplantation, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Fatmanur Çelik Başaran
- Clinic of Thoracic Surgery and Lung Transplantation, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Mehmet Furkan Şahin
- Clinic of Thoracic Surgery and Lung Transplantation, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Muhammet Ali Beyoğlu
- Clinic of Thoracic Surgery and Lung Transplantation, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Mustafa Bindal
- Clinic of Anesthesiology and Reanimation, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Alkın Yazıcıoğlu
- Clinic of Thoracic Surgery and Lung Transplantation, Ankara Bilkent City Hospital, Ankara, Türkiye
| | - Erdal Yekeler
- Clinic of Thoracic Surgery and Lung Transplantation, Ankara Bilkent City Hospital, Ankara, Türkiye
| |
Collapse
|
6
|
Beyoglu MA, Sahin MF, Saglam MF, Ercelik HU, Guresci S, Yekeler E. A pulmonary mass extending into the left atrium through the pulmonary vein: a rare diagnosis with an unusual origin. Acta Chir Belg 2023:1-4. [PMID: 37470421 DOI: 10.1080/00015458.2023.2239550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Myxofibrosarcoma usually occurs in the extremities of middle-aged to older adults. Metastatic myxofibrosarcomas generally emerge in the lung. In this case report, we aim to present a case of primary pulmonary myxofibrosarcoma with tumor thrombus extending into the left atrium without pulmonary vein or atrial invasion. CASE PRESENTATION A 55-year-old male who was being followed up due to a pulmonary nodule presented with a mass extending from the left lower lobe to the left atrium. No extrathoracic malignancy was detected in the pre-operative examination. The mass extending into the left atrium without invasion was excised with the lower lobe of the left lung. A post-operative histopathological examination revealed myxofibrosarcoma. CONCLUSION Very few cases of cervical, thoracic wall, mediastinum and cardiac primary myxofibrosarcoma have been documented, and to the best of our knowledge, only one primary pulmonary myxofibrosarcoma case has previously been reported in the English literature. Here, we present a case of primary pulmonary myxofibrosarcoma that extended to the left atrium through the pulmonary vein. In such rare clinical presentations, intracardiac tumor resection should precede pulmonary resection due to the possibility of catastrophic tumor embolisms.
Collapse
Affiliation(s)
- Muhammet Ali Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Furkan Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Huseyin Unsal Ercelik
- Department of Cardiovascular Surgery, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Servet Guresci
- Department of Pathology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
7
|
Sahin MF, Beyoglu MA, Yazicioglu A, Turkkan S, Yiğit Özay H, Akbulut ED, Neselioglu S, Erel O, Yekeler E. Dynamic Thiol-Disulfide Homeostasis as a Marker for Oxidative Stress in Lung Transplant Candidates. EXP CLIN TRANSPLANT 2023; 21:526-533. [PMID: 35867015 DOI: 10.6002/ect.2022.0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Oxidative stress developing due to oxidant/antioxidant imbalance plays a crucial role in the etiopathogenesis of chronic progressive lung diseases.The condition is typically more severe in lung transplant candidates with end-stage lung disease. Here, we investigated dynamic thiol-disulfide homeostasis as a marker for oxidative stress in lung transplant candidates. MATERIALS AND METHODS The study included 40 patients with end-stage lung disease with indications for lung transplant (candidate group) and 40 healthy controls. Patient demographic data, laboratory results, and thiol-disulfide homeostasis values were recorded. We categorized patients according to their primary diseases and noted clinical measurements of forced expiratory volume in 1 second, forced vital capacity, 6-minute walk test, systolic pulmonary artery pressure, and lung allocation scores.Thiol-disulfide homeostasis parameters were compared before and after transplant. RESULTS Demographic characteristics were similar in the candidate and control groups. In the candidate group, native thiol and total thiol levels (antioxidant parameters of thiol-disulfide homeostasis) were significantly lower, whereas disulfide-to-native thiol and disulfide-to-total thiol ratios (oxidant parameters of thiol-disulfide homeostasis) were significantly higher. We observed no significant differences between the disease subgroups in terms of thioldisulfide homeostasis parameters. Moderately significant correlations were shown between the antioxidant markers ofthiol-disulfide homeostasis and the clinical measurements, including the lung allocation scores. Our multiple regression analyses showed that native thiol and total thiol were significant predictive factors to estimate the lung allocation score. During the study period, 6 patients (15%)received lung transplant. There were significant differences in antioxidant parameters ofthiol-disulfide homeostasis in the pre- versus posttransplant periods. CONCLUSIONS In patients with end-stage lung disease, the dynamic thiol-disulfide homeostasis status is altered in favor of oxidants. Thus, thiol-disulfide homeostasis parameters can be used to detect oxidative stress and estimate lung allocation scores in these patients. Lung transplant may have positive effects on oxidative stress.
Collapse
Affiliation(s)
- Mehmet Furkan Sahin
- From the Department of General Thoracic Surgery and Lung Transplantation; University of Health Sciences, Ankara, Turkey
| | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Sahin MF, Yazicioglu A, Zengin NI, Yekeler E. Thoracic benign cystic mesothelioma. Acta Chir Belg 2023; 123:192-194. [PMID: 34304700 DOI: 10.1080/00015458.2021.1959781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Benign cystic mesotheliomas (BCMs), also known as multilocular mesothelial inclusion cysts, inflammatory inclusion cysts or multicystic mesothelial proliferation, are frequently observed in females and are localised localised in the pelvic peritoneum. They are rarely present in the thoracic and mediastinal areas; however, these locations have been reported in a few cases in the literature. CASE PRESENTATION We present the case of a woman with an intrathoracic BCM. A 28-year-old female patient presented with a cystic mass of 8 × 6 × 6 cm in the left hemithorax shown by computed tomography of the thorax. The patient underwent cystic mass excision with video-assisted thoracoscopic surgery (VATS), which was completed without complications. The diagnosis was confirmed histopathologically after the surgical resection. CONCLUSIONS Due to BCMs' non-specific clinical symptoms and radiological imaging, preoperative diagnosis is difficult, and they are often confused with pericardial cysts. There is no standard treatment protocol; however, VATS and en bloc resection are the most frequently used treatment options for mediastinal localization. Since these lesions slow proliferation rates have the potential for local recurrence and low malignant transformation, close follow-up is recommended. In this case report, we aimed to present a rare BCM case with intrathoracic paracardiac localization was completely excised through VATS. No recurrence has been detected in three years of follow-up.
Collapse
Affiliation(s)
- M Furkan Sahin
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - Alkin Yazicioglu
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - Neslihan Inci Zengin
- Department of Pathology, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| | - Erdal Yekeler
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences Turkey, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
9
|
Beyoglu MA, Sahin MF, Yazicioglu A, Yekeler E. Neo-carina after carina resection and right upper lobectomy in a patient with adenoid cystic carcinoma: Alternative technique. Indian J Cancer 2023; 0:370672. [PMID: 36861726 DOI: 10.4103/ijc.ijc_622_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Surgical treatment of carinal tumors that extend into the lobar bronchus is a procedure that challenges thoracic surgeons. There is no consensus on the suitable technique for a safe anastomosis in lobar lung resection with carina. The preferred Barclay technique has a high rate of anastomosis-related complications. Although a lobe-sparing end-to-end anastomosis technique has been previously described, the double-barrel method can be applied as an alternative technique. We present a case where we performed double-barrel anastomosis and neo-carina formation after tracheal sleeve right upper lobectomy.
Collapse
Affiliation(s)
- Muhammet A Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet F Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Alkin Yazicioglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
10
|
Türkkan S, Yılmaz E, Bindal M, Çelik Başaran F, Şahin MF, Beyoğlu MA, Yazıcıoğlu A, Yekeler E. The Effect of Ideal/Standard Donor and Marginal Donor Use on Primary Graft Dysfunction After Lung Transplantation in Turkey. Eurasian J Med 2023; 55:69-73. [PMID: 36861870 PMCID: PMC10081002 DOI: 10.5152/eurasianjmed.2023.23007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE The transplantation waiting list is getting longer day by day with the spread of lung transplantation and awareness of it. However, the donor pool cannot keep up with this rate. Therefore, nonstandard (marginal) donors are widely used. By studying the lung donors presented at our center, we aimed to raise awareness of the donor shortage and compare clinical outcomes in recipients with standard and marginal donors. MATERIALS AND METHODS The data from recipients and donors of lung transplants performed at our center between March 2013 and November 2022 were retrospectively reviewed and recorded. Transplants with ideal and standard donors were classified as group 1, and those with marginal donors were classified as group 2. Primary graft dysfunction rates, intensive care unit, and hospital stay days were compared. RESULTS Eighty-nine lung transplants were performed. A total of 46 recipients were in group 1 and 43 were in group 2. There were no differences between groups in the development of stage 3 primary graft dysfunction. However, a significant difference was found in the marginal group for developing any stage primary graft dysfunction. Donors were mostly from the western and southern regions of the country and from the education and research hospitals. CONCLUSION Because of the donor shortage in lung transplantation, transplant teams tend to use marginal donors. Stimulating and supportive education for healthcare professionals to recognize brain death and public education to raise awareness about organ donation are necessary to spread organ donation throughout the country. Although our results using marginal donors are similar with the standard group, each recipient and donor should be assessed individually.
Collapse
Affiliation(s)
- Sinan Türkkan
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| | - Emre Yılmaz
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| | - Mustafa Bindal
- University of Health Sciences Turkey, Ankara City Hospital, Department of Anesthesiology and Reanimation
| | - Fatmanur Çelik Başaran
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| | - Mehmet Furkan Şahin
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| | - Muhammet Ali Beyoğlu
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| | - Alkın Yazıcıoğlu
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| | - Erdal Yekeler
- University of Health Sciences Turkey, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation
| |
Collapse
|
11
|
Marro M, Leiva-Juárez MM, D'Ovidio F, Chan J, Van Raemdonck D, Ceulemans LJ, Moreno P, Kindelan AA, Krueger T, Koutsokera A, Ehrsam JP, Inci I, Yazicioglu A, Yekeler E, Boffini M, Brioude G, Thomas PA, Pizanis N, Aigner C, Schiavon M, Rea F, Anile M, Venuta F, Keshavjee S. Lung Transplantation for Primary Ciliary Dyskinesia and Kartagener Syndrome: A Multicenter Study. Transpl Int 2023; 36:10819. [PMID: 36865666 PMCID: PMC9970992 DOI: 10.3389/ti.2023.10819] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023]
Abstract
Primary ciliary dyskinesia, with or without situs abnormalities, is a rare lung disease that can lead to an irreversible lung damage that may progress to respiratory failure. Lung transplant can be considered in end-stage disease. This study describes the outcomes of the largest lung transplant population for PCD and for PCD with situs abnormalities, also identified as Kartagener's syndrome. Retrospectively collected data of 36 patients who underwent lung transplantation for PCD from 1995 to 2020 with or without SA as part of the European Society of Thoracic Surgeons Lung Transplantation Working Group on rare diseases. Primary outcomes of interest included survival and freedom from chronic lung allograft dysfunction. Secondary outcomes included primary graft dysfunction within 72 h and the rate of rejection ≥A2 within the first year. Among PCD recipients with and without SA, the mean overall and CLAD-free survival were 5.9 and 5.2 years with no significant differences between groups in terms of time to CLAD (HR: 0.92, 95% CI: 0.27-3.14, p = 0.894) or mortality (HR: 0.45, 95% CI: 0.14-1.43, p = 0.178). Postoperative rates of PGD were comparable between groups; rejection grades ≥A2 on first biopsy or within the first year was more common in patients with SA. This study provides a valuable insight on international practices of lung transplantation in patients with PCD. Lung transplantation is an acceptable treatment option in this population.
Collapse
Affiliation(s)
- Matteo Marro
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Miguel M Leiva-Juárez
- Division of Thoracic Surgery, Columbia University Medical Center, New York, NY, United States
| | - Frank D'Ovidio
- Division of Thoracic Surgery, Columbia University Medical Center, New York, NY, United States
| | - Justin Chan
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | | | - Paula Moreno
- Thoracic Surgery and Lung Transplantation Unit, University Hospital Reina Sofia, Cordoba, Spain
| | | | - Thorsten Krueger
- Division of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Angela Koutsokera
- Division of Thoracic Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Jonas Peter Ehrsam
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Ilhan Inci
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Alkin Yazicioglu
- Department of Thoracic Surgery, University of Health Sciences, Ankara, Türkiye
| | - Erdal Yekeler
- Department of Thoracic Surgery, University of Health Sciences, Ankara, Türkiye
| | - Massimo Boffini
- Division of Cardiac Surgery, University of Turin, Turin, Italy
| | - Geoffrey Brioude
- Division of Thoracic Surgery, University of Marseilles, Marseille, France
| | | | - Nikolaus Pizanis
- Department of Thoracic Surgery, University Hospital Essen, Essen, Germany
| | - Clemens Aigner
- Department of Thoracic Surgery, University Hospital Essen, Essen, Germany
| | - Marco Schiavon
- Department of Cardio-Thoracic Surgery, Padua University Hospital, Padua, Italy
| | - Federico Rea
- Department of Cardio-Thoracic Surgery, Padua University Hospital, Padua, Italy
| | - Marco Anile
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Federico Venuta
- Division of Thoracic Surgery, Policlinico Umberto I, Sapienza University, Rome, Italy
| | - Shaf Keshavjee
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada
| |
Collapse
|
12
|
Sahin MF, Beyoglu MA, Kıran MM, Yekeler E. A rare lung tumor: Primary pulmonary synovial sarcoma. J Cancer Res Ther 2023; 19:S901-S903. [PMID: 38384075 DOI: 10.4103/jcrt.jcrt_1810_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 05/23/2022] [Indexed: 02/23/2024]
Abstract
ABSTRACT Synovial sarcoma is one of the rare soft tissue sarcomas occurring in the periarticular region originating from synovia. Synovial sarcomas occur less frequently in the neck, tongue, larynx, mediastinum, heart, lung, abdominal wall, small intestine, mesentery, and retroperitoneum. Primary pulmonary synovial sarcoma is a poor pathological condition without extrapulmonary involvement. In these rapidly progressing tumors, making quick decisions is important and performing complete resection is the best treatment that contributes to survival. Herein, we present a case of primary pulmonary synovial sarcoma in which we were able to achieve long-term survival with the multimodal approach after complete resection.
Collapse
Affiliation(s)
- Mehmet F Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Muhammet A Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Merve M Kıran
- Department of Pathology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
13
|
Ar U, Yekeler E, Calik-Kutukcu E. Body Function and Structure, Activity, and Participation Limitations of Lung Transplant Recipients Within the Scope of the International Classification of Functioning, Disability, and Health. EXP CLIN TRANSPLANT 2022. [PMID: 36259610 DOI: 10.6002/ect.2022.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES There is no study in the literature that specifically evaluates lung transplant recipients in the long-term under the framework of the International Classification of Functioning, Disability, and Health. The aim of this study was to evaluate the relationships between lung transplant recipient age, age at transplant, and comorbidity levels and the body structure and functions and the activity and participation levels of patients within the scope of the International Classification of Functioning, Disability, and Health. MATERIALS AND METHODS We evaluated 27 lung transplant recipients according to the International Classification of Functioning, Disability, and Health items in domain b (body functions), domain s (body structures), and domain d (activities and participation). For domain b, sleep functions, psychosocial status, respiratory functions, and upper and lower extremity exercise capacity were evaluated. Posture was evaluated for the s domain. Balance, arm functional capacity, health-related quality of life, and physical activity were evaluated for domain d. RESULTS As the age of lung transplant recipients and the age at transplant increase, their sleep quality and respiratory functions decreased, and postural impairment increased. There was a negative correlation between age at transplant and functional exercise capacity (P < .05). As the comorbidity level of the recipient increases, the upper and lower extremity exercise capacity, physical activity level, and quality of life declined. There was a moderately positive correlation between the level of comorbidity and balance disorder (P < .05). CONCLUSIONS We found the International Classification of Functioning, Disability, and Health framework to be useful for the evaluation and for planning pulmonary rehabilitation for lung transplant recipients; it can bring a new perspective to physiotherapists specialized in cardiopulmonary rehabilitation.
Collapse
Affiliation(s)
- Ulas Ar
- From the Thoracic Surgery Clinic, Ankara City Hospital, Ankara, Turkey
| | | | | |
Collapse
|
14
|
Turkkan S, Basaran FC, Sahin MF, Beyoglu MA, Yilmaz E, Ozay HY, Bindal M, Yazicioglu A, Yekeler E. Everolimus Use in Lung Transplant Recipients. Transplant Proc 2022; 54:2317-2324. [PMID: 36192210 DOI: 10.1016/j.transproceed.2022.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/09/2022] [Accepted: 08/26/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Most lung transplantation centers prefer triple immunosuppressive therapy with tacrolimus, mycophenolate mofetil, and corticosteroids. However, to prevent complications and comorbidities caused by tacrolimus, replacing the drug with everolimus has been considered. METHODS This is a retrospective observational study investigating everolimus switch for different reasons. The population was divided into 3 groups: chronic lung allograft dysfunction (CLAD), kidney impairment, and malignant neoplasm groups. We investigated whether we achieved the goal of the switch and the frequency of rejection, cytomegalovirus and fungal infections, and everolimus adverse effects. RESULTS Nineteen patients received everolimus therapy, and 5 of these were for CLAD, 7 for tacrolimus nephrotoxicity, and 7 for explant/de novo malignant neoplasm. The patients were followed up for a mean (SD) of 30 (16.7) months under the therapy. The number of acute cellular rejection, cytomegalovirus infection, and aspergillosis infection cases before switch were 7, 13, and 2, respectively, and 7, 2, and 3 after that. The mean values of creatinine and estimated glomerular filtration rate of the whole population after the switch improved with no statistical significance, whereas it was significant in tacrolimus nephrotoxicity group. Three patients in the CLAD group remained stable after switching, whereas 2 progressed. Only 1 of the 7 patients with malignant neoplasms had a recurrence during 31.1 (16.5) months of median follow-up. Eleven cases of everolimus adverse effects occurred in 9 patients (47.3%), with 2 (10.5%) withdrawal events. Kidney impairment (P = .02) and age (P = .05) stood out as significant risk factors for drug adverse effects. CONCLUSIONS After lung transplant, everolimus can be a safe alternative for immunosuppression with acceptable adverse effects.
Collapse
Affiliation(s)
- Sinan Turkkan
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey.
| | - Fatmanur Celik Basaran
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Furkan Sahin
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Muhammet Ali Beyoglu
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Emre Yilmaz
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Hülya Yigit Ozay
- Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Mustafa Bindal
- Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Alkin Yazicioglu
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Erdal Yekeler
- Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
15
|
Ozay HY, Bindal M, Turkkan S, Beyoglu MA, Yekeler E, Turan S. Delirium Development After Lung Transplantation: An Intraoperative Assessment. Transplant Proc 2022; 54:1906-1912. [PMID: 35985880 DOI: 10.1016/j.transproceed.2022.03.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/27/2022] [Accepted: 03/26/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to evaluate the relationship between intraoperative hemodynamic and laboratory parameters with postoperative delirium development after lung transplantation. METHODS A total of 77 patients who underwent lung transplantation in a single center were included in the study. Demographic and clinical data recorded at critical intraoperative stages (after induction [T1], after bilateral lungs are dissected [T2], while the patient is ventilated for 1 lung [T3], while the unilateral transplanted lung is ventilated [T4], while bilateral transplanted lungs are ventilated [T5], and after the thorax is closed [T6]), postoperative complications, mechanical ventilation duration, intensive care, and hospitalization durations and mortality rates were recorded. RESULTS A total of 83.1% of the 77 patients were male, and the mean (SD) age was 47.56 (12.95) years. The mean body mass index (calculated as weight in kilograms divided by height in meters squared) was 23.30 (3.99), and the median Charles Comorbidity Index (CCI) was 1. The diagnosis of 36.4% of the patients was chronic obstructive pulmonary disease. Delirium was seen in 51.9% of the patients. Age, CCI, intraoperative mean arterial pressure changes, lactate levels, mechanical ventilation duration, and hospital stay were all associated with delirium development. CONCLUSION Age, CCI, duration of mechanical ventilation, and hospital stay were independent predictors of postoperative delirium development. We believe that our study will be a guide for future prospective randomized controlled studies.
Collapse
Affiliation(s)
- Hulya Yigit Ozay
- Department of Anesthesiology and Reanimation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Bindal
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Sinan Turkkan
- Department of Anesthesiology and Reanimation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey; Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Muhammet Ali Beyoglu
- Department of Anesthesiology and Reanimation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey; Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Erdal Yekeler
- Department of Anesthesiology and Reanimation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey; Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Sema Turan
- Department of Anesthesiology and Reanimation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey; Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
16
|
Beyoglu MA, Sahin MF, Turkkan S, Yazicioglu A, Yekeler E. Complex Post-intubation Tracheal Stenosis in Covid-19 Patients. Indian J Surg 2022; 84:805-813. [PMID: 35818393 PMCID: PMC9261125 DOI: 10.1007/s12262-022-03498-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 07/01/2022] [Indexed: 11/26/2022] Open
Abstract
Management of tracheal complications due to endotracheal intubation in patients with coronavirus disease-2019 (COVID-19) is an important concern. This study aimed to present the results of patients who had undergone tracheal resection and reconstruction due to COVID-19-related complex post-intubation tracheal stenosis (PITS). We evaluated 15 patients who underwent tracheal resection and reconstruction due to complex PITS between March 2020 and April 2021 in a single center. Seven patients (46.6%) who underwent endotracheal intubation due to the COVID-19 constituted the COVID-19 group, and the remaining 8 patients (53.4%) constituted the non-COVID-19 group. We analyzed the patients’ presenting symptoms, time to onset of symptoms, radiological and bronchoscopic features of stenosis, bronchoscopic intervention history, length of the resected tracheal segment, postoperative complications, length of hospital stay, and duration of follow-up. Six of the patients (40%) were female, and 9 (60%) were male. Mean age was 43.3 ± 20.5. We found no statistically significant difference between the COVID-19 and non-COVID-19 PITS groups in terms of presenting symptoms, time to onset of symptoms, stenosis location, stenosis severity, length of the stenotic segment, number of bronchoscopic dilatation sessions, dilatation time intervals, length of the resected tracheal segment, postoperative complications, and length of postoperative hospital stay. Endotracheal intubation duration was longer in the COVID-19 group than non-COVID-19 group (mean ± SD: 21.0 ± 4.04, 12.0 ± 1.15 days, respectively). Tracheal resection and reconstruction can be performed safely and successfully in COVID-19 patients with complex PITS. Comprehensive preoperative examination, appropriate selection of surgery technique, and close postoperative follow-up have favorable results.
Collapse
Affiliation(s)
- Muhammet Ali Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, MH2 Binasi, B1 Kati, E2 Bolumu, Universiteler Mahallesi 1604, Cadde No: 9, Çankaya, Ankara, Turkey
| | - Mehmet Furkan Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, MH2 Binasi, B1 Kati, E2 Bolumu, Universiteler Mahallesi 1604, Cadde No: 9, Çankaya, Ankara, Turkey
| | - Sinan Turkkan
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, MH2 Binasi, B1 Kati, E2 Bolumu, Universiteler Mahallesi 1604, Cadde No: 9, Çankaya, Ankara, Turkey
| | - Alkin Yazicioglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, MH2 Binasi, B1 Kati, E2 Bolumu, Universiteler Mahallesi 1604, Cadde No: 9, Çankaya, Ankara, Turkey
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, MH2 Binasi, B1 Kati, E2 Bolumu, Universiteler Mahallesi 1604, Cadde No: 9, Çankaya, Ankara, Turkey
| |
Collapse
|
17
|
Turkkan S, Celik Basaran F, Sahin MF, Beyoğlu MA, Yılmaz E, Yazıcıoğlu A, Yigit Ozay H, Bindal M, Tezer Tekce Y, Yekeler E. COVID-19 After Vaccination in Lung Transplant Recipients: Real-Life Data. EXP CLIN TRANSPLANT 2022; 21:265-271. [PMID: 35867010 DOI: 10.6002/ect.2022.0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The effectiveness of COVID-19 vaccines in lung transplant recipients is unclear. We retrospectively analyzed lung transplant recipients vaccinated with an inactivated virus vaccine (CoronaVac) and the mRNA vaccine BNT162b2 used against the SARS-CoV-2 virus in Turkey and shared their effects on COVID-19. MATERIALS AND METHODS Demographic data of lung transplant recipients followed up for >3 months were collected, and vaccination dates and status against the SARS-CoV-2 virus were recorded. Recipients who received at least 3 doses of CoronaVac or 2 doses of BNT162b2, or 1 dose of CoronaVac plus 2 doses of BNT162b2, or 2 doses of CoronaVac plus 1 dose of BNT162b2 were considered fully vaccinated; those who were vaccinated less than this number were considered partially vaccinated. Patients with positive SARS-CoV-2 reverse transcription-polymerase chain reaction tests from respiratory tract samples were accepted as positive for COVID-19. Recipients were classified by number and type of vaccine, and groups were compared for infection, need for intensive care, and death as a result of COVID-19. RESULTS Of the 53 lung transplant recipients, 51 were vaccinated (7 partially vaccinated, 44 fully vaccinated) and 2 were not vaccinated. Of fully vaccinated recipients, 13/44 received the inactivated vaccine, 5/44 received the mRNA vaccine, and 26/44 had a combination of the 2 vaccines. During the follow-up period, 13 patients (2/2 not vaccinated, 2/7 [28.5%] partially vaccinated, 9/44 [20.5%] fully vaccinated) were diagnosed with COVID-19. There was no significant difference in protection against infection between the inactivated, the mRNA, and combined vaccine groups. There was no significant association in cycle threshold values that determine the infection load and COVID-19 severity between transplant recipients who died and those who did not. CONCLUSIONS In lung transplant recipients, 3 doses of inactivated vaccine, 2 doses of mRNA vaccine, or the combined heterologous vaccine provided similar protection. Prevention of exposure is one of the most crucial steps.
Collapse
|
18
|
Beyoglu M, Sahin F, Albayrak A, Yekeler E. An extremely rare tracheal tumor in coronavirus disease-2019 screening: Marginal zone lymphoma. J Cancer Res Ther 2022. [DOI: 10.4103/jcrt.jcrt_1645_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
19
|
Beyoglu MA, Sahin MF, Turkkan S, Basaran FC, Yazicioglu A, Bektas SG, Tekce YT, Yekeler E. Vaccine Breakthrough Severe COVID-19 in a Lung Recipient. Transplant Proc 2021; 54:1569-1571. [PMID: 34887098 PMCID: PMC8585586 DOI: 10.1016/j.transproceed.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 11/26/2022]
Abstract
The vaccines developed against severe acute respiratory syndrome coronavirus 2 are seen as the most crucial weapon in controlling the epidemic. It has been reported in early-stage vaccine studies that vaccines provide up to 95% protection against severe disease and mortality, even in the absence of symptomatic infection. Reports on vaccine breakthrough infections that developed after widespread vaccination are available in the literature. In addition to the general population, the course of vaccine breakthrough infections in immunocompromised patients is a matter of concern. This case report aimed to define severe coronavirus disease 2019 developing in a lung recipient who received 3 doses of inactivated virus vaccine.
Collapse
Affiliation(s)
- Muhammet Ali Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Mehmet Furkan Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Sinan Turkkan
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Fatmanur Celik Basaran
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Alkin Yazicioglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Serife Gokbulut Bektas
- Department of Intensive Care Unit, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Yasemin Tezer Tekce
- Clinic of Infectious Disease, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
20
|
Cankar Dal H, Eren N, Kazanci D, Yekeler E, Türkkan S, Turan S. COVID-19 Pneumonia and Intensive Care Treatment of a Lung Transplant Recipient. EXP CLIN TRANSPLANT 2021; 20:786-788. [PMID: 34546156 DOI: 10.6002/ect.2021.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In the COVID-19 pandemic presently affecting the whole world, solid-organ transplant recipients under immunosuppressive therapy are at higher risk than the general population. COVID-19 infection primarily affects the lungs, and so the risk is further increased in lung transplant recipients. The course of COVID-19 in lung transplant recipients is unclear. Here, we present the intensive care follow-up and treatment process of a bilateral lung transplant recipient who developed acute respiratory failure due to COVID-19, for whom the final outcome was favorable. Antiviral treatment was initiated for the 53-year-old male patient with COVID19 pneumonia, and in the following hyperinflammatory phase, high-dose pulse steroid therapy was administered. The patient was followed up with highflow nasal oxygen, and then he was supported by intermittent noninvasive mechanical ventilation as hypoxia became more severe. With these noninvasive ventilation strategies and good intensive care procedures, the patient was successfully discharged.
Collapse
Affiliation(s)
- Hayriye Cankar Dal
- From the Department of Intensive Care Unit, Ankara City Hospital, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
21
|
Beyoglu MA, Sahin MF, Turkkan S, Yazicioglu A, Demirag F, Yekeler E. Diffuse Panbronchiolitis After Lung Transplantation: First Case in the Literature. Transplant Proc 2021; 53:2622-2625. [PMID: 34470700 DOI: 10.1016/j.transproceed.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Diffuse panbronchiolitis is a chronic airway disease characterized by diffuse inflammation of respiratory bronchioles and peribronchial tissue. We present a case of diffuse panbronchiolitis developed after lung transplantation, which to our knowledge has not been previously described in the literature. CASE REPORT A 52-year-old white woman was admitted with reports of weakness, shortness of breath, and productive cough 6 months after bilateral sequential lung transplantation. Thorax computed tomography revealed the appearance of a budding branch pattern in the lower lobes of both lungs. Repeated transbronchial lung biopsies were not diagnostic. A lower lobe wedge biopsy with thoracotomy was performed in the patient, whose respiratory function gradually deteriorated. Dense lymphocyte infiltration in the respiratory bronchiole wall and foamy macrophage groups in the adjacent interstitial area were detected in the histopathologic sections. The dramatic response was achieved with pulse steroid therapy in a short time. Rapidly worsening clinical course and response to the pulse steroid therapy suggested acute cellular rejection. CONCLUSIONS Acute cellular rejection is expected within the first year in lung transplant recipients. Diffuse panbronchiolitis may be a kind of clinical presentation in lung recipients and should be considered in patients who develop severe graft function loss in a short time.
Collapse
Affiliation(s)
- Muhammet Ali Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Mehmet Furkan Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Sinan Turkkan
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Alkın Yazicioglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Funda Demirag
- Department of Pathology, Ataturk Chest Disease and Thoracic Surgery Hospital, Ankara, Turkey
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
22
|
Turkkan S, Beyoglu MA, Sahin MF, Yazicioglu A, Tezer Tekce Y, Yekeler E. COVID-19 in lung transplant recipients: A single-center experience. Transpl Infect Dis 2021; 23:e13700. [PMID: 34323353 PMCID: PMC8420517 DOI: 10.1111/tid.13700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/07/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a global health problem. However, the course of this disease in immunosuppressed patients remains unknown. This study aimed to describe the course of COVID-19 infection and its effects on lung transplant recipients. METHODS This was a single-center, retrospective, observational study. The recipients with suspicious symptoms and/or a contact history with infected individuals were diagnosed with COVID-19 by performing a reverse transcription-polymerase chain reaction (RT-PCR) test using samples obtained from the nasopharynx swabs or bronchial lavage. We classified the patients into mild, moderate, and high severity groups according to their clinical conditions. In patients with positive RT-PCR results, cell cycle inhibitor drugs were withdrawn, while steroids were maintained at the same level as in patients without clinical deterioration. RESULTS Of the seven recipients diagnosed with COVID-19 infection, one experienced a re-infection. Each recipient had at least one comorbidity. Smell disorder (12.5%), cough/dyspnea (37%), and fever/chills/shivering (37%) were the most frequent symptoms. The mean follow-up time after infection was 108 days. No deaths were recorded due to COVID-19; however, the pulmonary function test values of two recipients were decreased during subsequent follow-ups. CONCLUSION In our small group of transplant recipients with COVID-19, there were two cases of pulmonary function deterioration and a case of re-infection, and no recipient died. It is suggested that steroid therapy should be initiated in the early period in patients with pulmonary opacities.
Collapse
Affiliation(s)
- Sinan Turkkan
- Department of Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Muhammet Ali Beyoglu
- Department of Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Furkan Sahin
- Department of Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Alkın Yazicioglu
- Department of Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Yasemin Tezer Tekce
- Department of Infectious Diseases, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Erdal Yekeler
- Department of Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| |
Collapse
|
23
|
Sahin MF, Beyoglu MA, Yazicioglu A, Yekeler E. Analysis of 40 patients who underwent tracheal resection due to benign complex tracheal stenosis. Asian J Surg 2021; 45:213-219. [PMID: 34052083 DOI: 10.1016/j.asjsur.2021.04.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Benign tracheal stenosis is a common complication in patients followed up in intensive care units. We aimed to analyze the etiology, diagnostic approaches, treatment methods for benign tracheal stenosis, and the predicting factors for complications after tracheal resection for benign stenosis. MATERIAL-METHOD Forty patients who underwent tracheal resection reconstruction due to benign tracheal stenosis were analyzed retrospectively. Predictive factors for complications were determined by statistical analysis. RESULTS There were 23 patients (57.5%) in the intubation group, 11 patients (27.5%) in the tracheostomy group, and 6 patients (15%) in the subsequent tracheostomy group. Preoperatively, rigid dilatation was applied to all patients between 2 and 6 sessions (median = 3). Tracheal resections were performed in all patients after rigid dilatations. The mean of the resected segment lengths is 32.1 ± 8.8 mm. There was a statistically significant difference between preoperative bronchoscopic measurements, preoperative tomography measurements, and intraoperative measurements of the stenosis segment (ꭓ2 (2) = 71,500; p < 0.001). The patients' mean follow-up period was 27.4 ± 21.7 months (3-84). Mortality due to tracheal surgery and major anastomotic complications were not observed. The minor anastomotic complication rate was 12.5%, the non-anastomotic complication rate was 17.5%. The effect of resection length and surgical experience were found to be statistically significant risk factors for anastomotic complications. CONCLUSIONS Rigid dilatation does not provide significant palliation in complex stenosis. Bronchoscopic measurements give closer results than CT measurements in the preoperative estimation of resection length. The risk of anastomotic complications increases when the length of the resection increases and when the surgical experience is less.
Collapse
Affiliation(s)
- Mehmet Furkan Sahin
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Muhammet Ali Beyoglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Alkin Yazicioglu
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| | - Erdal Yekeler
- Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey.
| |
Collapse
|
24
|
Turkkan S, Beyoglu MA, Sahin MF, Yazicioglu A, Yigit Ozay H, Tezer Tekçe Y, Demirag F, Yekeler E. COVID-19 in a Lung Transplant Patient: Rapid Progressive Chronic Lung Allograft Dysfunction. EXP CLIN TRANSPLANT 2021. [PMID: 33928873 DOI: 10.6002/ect.2020.0563] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The pandemic of SARS-CoV-2, known as COVID-19, has continued to show its effect all over the world. The clinical course of the disease in solid-organ transplant recipients is a matter of concern. Lung transplant recipients also demonstrate special features because the graft encounters the COVID-19 pathogen directly as a result of inhalation, and the lungs are the most important organs affected by the disease. We shared the development process of acute rejection followed by rapid progression of chronic lung allograft dysfunction after COVID-19 in a recipient who was followed-up in the fifth year after lung transplant.
Collapse
Affiliation(s)
- Sinan Turkkan
- From the University of Health Sciences, Ankara City Hospital, Department of Thoracic Surgery and Lung Transplantation, Ankara, Turkey
| | | | | | | | | | | | | | | |
Collapse
|
25
|
Sahin MF, Beyoglu MA, Turkkan S, Tezer Tekce Y, Yazicioglu A, Yekeler E. Donor Lung Evaluation and Lung Transplantation in the COVID-19 Era. EXP CLIN TRANSPLANT 2021; 20:842-848. [PMID: 33928880 DOI: 10.6002/ect.2020.0567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The COVID-19 pandemic, which emerged in late 2019, adversely affected all solid-organ transplant processes. Here we share the donor presentations evaluated in a lung transplant center during the COVID-19 pandemic, the measures taken at every stage of transplant management, and the outcomes of our transplants. MATERIALS AND METHODS Data from 15 lung donors selected by the national coordination center pre - sented to our lung transplant center as of March 11, 2020, when the first COVID-19 case was reported in Turkey, and data of 5 lung transplant cases in this period were retrospectively analyzed. All donors were examined in detail for COVID-19 disease. Procurement processes for accepted donors, transplant surgeries of recipients, and postoperative follow-up and care processes of recipients were carried out with the least number of personnel, but all with appropriate personal protective equipment. RESULTS There were 15 donor organs procured by our center during a 9-month period coincident with the COVID-19 pandemic. The number of donor pre - sentations to our center between the same dates in the previous year was 78. Five of the 15 donors were accepted, and of those accepted, 4 were male and 1 was female. There was no statistically significant difference between the accepted and rejected donors in terms of the ratio of Pao2 to fraction of inspired oxygen, age, duration of endotracheal intubation (days), and smoking (pack-years). All SARS-CoV-2 reverse transcription-polymerase chain reaction tests performed on bronchoalveolar lavage samples and nasopharyngeal, conjunctival, and rectal samples collected from the recipients during the follow-up period were negative. No pathological finding suggestive of COVID-19 infection was noted in the radiological evaluations. CONCLUSIONS Lung transplant can be successfully managed during the COVID-19 pandemic period, despite the high risk of infection. The major obstacle to the continuity of lung transplant in this period was the limited number of donors.
Collapse
Affiliation(s)
- Mehmet Furkan Sahin
- From the Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | | | | | | |
Collapse
|
26
|
Beyoglu M, Turkkan S, Sahin M, Yazicioglu A, Demirag F, Yekeler E. Diffuse Panbronchiolitis after Lung Transplantation. A New Form of Acute Rejection? J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
27
|
Sahin MF, Beyoglu MA, Turkkan S, Yazicioglu A, Yekeler E. Submucosal Injection of Mitomycin-C Due to Development of Tracheal Restenosis After Resection. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
28
|
Türkkan S, Sahin M, Beyoglu M, Yazicioglu A, Tekce Y, Yekeler E. Four Cases of COVID-19 Infection in Lung Transplant Recipients. J Heart Lung Transplant 2021. [PMCID: PMC7979421 DOI: 10.1016/j.healun.2021.01.2040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction There are limited data about short and long-term problems caused by COVID-19 infection in lung transplant and other organ transplant recipients.We share the clinical,laboratory,radiological and treatment results of four lung transplant recipients after COVID-19 infection who were operated in our clinic. Case Report All patients had positive PCR tests for COVID-19,three of four patients had dyspnea and desaturation with ground glass areas on thorax CT.One patient only complained of impaired sense of smell.Three patients with signs of pneumonia were hospitalized and one patient was treated on an outpatient basis.While one of the patients received a combine therapy with favipiravir.hydroxychloroquine,azithromycin,3 patients received only favipiravir treatment.Three consecutive days of 1000 mg/day methylprednisolone treatment were used in 3 patients with signs of pneumonia and dyspnea,because symptoms did not improve.Death was not observed in any of the cases.The complaint of the patient,who had symptoms of impaired sense of smell,resolved within 5 days.Three patients with persistent dyspnea,desaturation,and radiological symptoms showed improvement in symptoms and radiological findings after pulse steroid therapy.In one of the cases,it was observed that the lesions caused interseptal thickening in the control tomography scan performed after three months. Summary There is limited data about the treatment and long-term results of Covid-19 infection.High dose steroid therapy may be a safe chose for the treatment of COVID-19 infection with signs of pneumonia in organ transplant recipients.However, further studies are needed to determine whether the disease leaves sequelae fibrotic areas in the lung or triggers /accelerates the CLAD process seen after lung transplantation.
Collapse
|
29
|
Sahin MF, Turkkan S, Beyoglu MA, Yazicioglu A, Yekeler E. Submucosal Injection of Mitomycin C in a Case of Vanishing Bronchus After Lung Transplant. EXP CLIN TRANSPLANT 2021; 20:627-629. [PMID: 33535935 DOI: 10.6002/ect.2020.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Segmental nonanastomotic stenosis, also known as vanishing bronchus intermedius syndrome (or simply, "vanishing bronchus"), is a rare complication that can occur after a lung transplant. It usually occurs in the first posttransplant year and often develops in the intermediate bronchus. Definitive diagnosis is established by bronchoscopy. The treatment management primarily includes bronchoscopic dilatation and stenting. In patients who do not benefit from these applications, lung resection or retransplant may be indicated. Our 58-year-old patient developed vanishing bronchus after lung transplant, and recurrence could not be prevented despite repeated bronchoscopic interventions. We applied submucosal mitomycin C injection to the bronchial wall of the stenotic segment and achieved significant benefit for reduction of recurrence. Our aim was to document the first reported case of a patient with vanishing bronchus who was treated with submucosal administration of mitomycin C, a strong fibroblast inhibitor, and to report the outcomes of submucosal mitomycin C administration with regard to recurrence.
Collapse
Affiliation(s)
- Mehmet Furkan Sahin
- From the Department of General Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | | | | |
Collapse
|
30
|
Yazicioglu A, Sahinoglu T, Uysal S, Subasi M, Demirag F, Yekeler E. The Efficacy and Safety of Different Sericin Doses for Pleurodesis. Arch Bronconeumol 2020; 56:225-233. [PMID: 32147281 DOI: 10.1016/j.arbres.2019.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/09/2019] [Accepted: 06/17/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aim of present study is to compare the effectiveness, side-effect potential of different doses of sericin pleurodesis. METHODS Adult, male, 12-week-old, Wistar-albino rats (n=52), were randomly-divided into four-groups, referred to A, B, C and D. Sericin was administrated at different doses through left thoracotomy, with 15mg sericin to Group-A, 30mg to Group-B and 45mg to Group-C. Group-D was assigned as control group. The rats were sacrificed 12 days later. Left-hemithorax, heart, liver and kidney were examined pathologically. RESULTS No foreign body reaction in the parenchyma was observed in any of the rats, while emphysema was least common in Group-B (P<.05). Multi-layer mesothelium of both pleura was most common in Group-B, while fibrosis and fibrin organization within the visceral-pleura was more successful in all of sericin treated groups than in control group (P<.05), with neither Group-A, Group-B nor Group-C being superior to each other. In the examination of collagen fibers using Masson's trichrome, "dense collagen fibers" were found in all three sericin treated groups, and differences between Groups-A, -B, -C and the control group were significant (P<.05). The probability of observing pyknotic nucleus and balloon degeneration in liver increased with increasing sericin doses (P<.05). Glomerular degeneration in kidney and the findings of pericarditis were most common in Group-C (P<.05). CONCLUSION The target should be to maximize efficacy while minimizing the likelihood of side-effects. The intrapleural administration of sericin 30mg performs better due to multi-layer mesothelial reaction being higher and emphysema being lower in Group-B, to the fewer side-effects affecting the kidney and heart, and liver toxicity not being higher.
Collapse
Affiliation(s)
- Alkin Yazicioglu
- SBU, Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey.
| | - Tuba Sahinoglu
- Konya Numune Hospital, Department of Thoracic Surgery, Konya, Turkey
| | - Serkan Uysal
- Ataturk Training and Research Hospital, Department of Thoracic Surgery, Ankara, Turkey
| | - Mahmut Subasi
- SBU, Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| | - Funda Demirag
- SBU, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pathology, Ankara, Turkey
| | - Erdal Yekeler
- SBU, Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| |
Collapse
|
31
|
Turkkan S, Subasi M, Celik Basaran F, Sahin MF, Yazicioglu A, Demirag F, Yekeler E. Rapidly Progressive Pulmonary Kaposi Sarcoma After Bilateral Sequential Lung Transplant: A Case Report. EXP CLIN TRANSPLANT 2020; 20:537-540. [PMID: 32133944 DOI: 10.6002/ect.2019.0246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Skin cancers are among the rarely seen complications after solid-organ transplant. Kaposi sarcoma invasion to an allograft is an uncommon condition. In this study, we present a case of Kaposi sarcoma in a 58-year-old patient diagnosed at 8 months after bilateral sequential lung transplant due to chronic obstructive pulmonary disease. Kaposi sarcoma showed rapid progression despite immunosuppressive drug modification, resulting in lung involvement and respiratory failure. Rapid and complete improvement was achieved with rapid diagnosis and aggressive treatment that included combined chemotherapy after surgery. The patient presented with no complications from Kaposi sarcoma at month 26 after transplant.
Collapse
Affiliation(s)
- Sinan Turkkan
- From the Department of Thoracic Surgery and Lung Transplantation, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | | | | | | | | |
Collapse
|
32
|
Yazicioglu A, Uysal S, Senat A, Sahinoglu T, Sahin MF, Biçer C, Erel Ö, Yekeler E. Does sericin pleurodesis increase the basic fibroblastic growth factor and high-sensitive c-reactive protein levels in rat plasma? Curr Thorac Surg 2020. [DOI: 10.26663/cts.2020.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
33
|
Demirag F, Yazicioglu A, Turkkan S, Tufekcioglu O, Yekeler E. Pulmonary Vascular Alterations in Explanted Lung after Transplantation. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
34
|
Sayan M, Turkkan S, Basaran F, Subasi M, Yazicioglu A, Sahin MF, Gungor A, Demirci N, Tekce Y, Demirag F, Yekeler E. Acute Rejection Presenting as Diffuse Panbronchiolitis After Lung Transplantation. Turk Thorac J 2019. [DOI: 10.5152/turkthoracj.2019.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
35
|
Yazicioglu A, Uysal S, Sahinoglu T, Subasi M, Demirag F, Yekeler E. Does Sericin, as a Novel Pleurodesis Agent, Have Higher Effectiveness Compared to Talcum Powder, Doxycycline, and Silver Nitrate Pleurodesis? Arch Bronconeumol 2018; 55:357-367. [PMID: 30473265 DOI: 10.1016/j.arbres.2018.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/08/2018] [Accepted: 10/08/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The usefulness of sericin as pleurodesis agent has previously been described. Present study aims to compare sericin pleurodesis regarding success, effectiveness, tolerability, and side-effects. METHODS Adult, 12-week-old Wistar-albino rats (n=60), divided to five groups as sericin, talcum-powder, doxycycline, silver-nitrate and control. Agents were administrated through left thoracotomy, rats sacrificed twelve-days after. RESULTS Highest ratio of collagen fibers was observed in sericin group, and the intensity was higher than talcum-powder group (p<0.05). Compared to silver nitrate, sericin group displayed better mesothelial reaction, and multi-layer mesothelium was also better (p<0.05). Foreign body reaction and emphysema were less frequent in sericin group (p<0.05). The presence of biological tissue in parenchyma was less prominent in sericin group (p<0.05). Foreign body reaction on thoracic wall was less common in sericin group (p<0.05). Presence of biological tissue glue in thoracic wall was less prominent in sericin group (p<0.05). Glomerular degeneration was lower in sericin group compared to the silver nitrate group (p<0.05), and tubular degeneration was less common in sericin group than talcum group (p<0.05). Pericarditis was less common in sericin group compared to the other groups (p<0.05). CONCLUSION As an intrinsic, natural glue protein, sericin protects the lung parenchyma and tissues, and its glue-like characteristics enable pleurodesis. The success of sericin in pleurodesis was demonstrated in the present study based on investigations of the pleurae. Being cost-effective and better tolerated agent associated with a low potential of side effects, sericin is more effective, less expensive and provides more lung parenchyma protection.
Collapse
Affiliation(s)
- Alkin Yazicioglu
- SBU, Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey.
| | - Serkan Uysal
- Bulent Ecevit University, Department of Thoracic Surgery, Zonguldak, Turkey
| | - Tuba Sahinoglu
- Konya Numune Hospital, Department of Thoracic Surgery, Konya, Turkey
| | - Mahmut Subasi
- SBU, Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| | - Funda Demirag
- SBU, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Pathology, Ankara, Turkey
| | - Erdal Yekeler
- SBU, Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| |
Collapse
|
36
|
Subasi M, Yazicioglu A, Gungor A, Saylan A, Turkkan S, Basaran F, Yekeler E. P-240A CASE OF PRIMARY ADENOID CYSTIC CARCINOMA OF TRACHEA: A COMPLEX SURGICAL APPROACH WITH DISTAL TRACHEAL, CARINAL RESECTION, RIGHT UPPER LOBECTOMY AND CARINAL RECONSTRUCTION. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
37
|
Yazicioglu A, Turkkan S, Demirag F, Subasi M, Yekeler E. Recurrence Pattern of Pulmonary Langerhans Cell Histiocytosis After Lung Transplantation: A Case Report. Transplant Proc 2016; 48:3231-3233. [DOI: 10.1016/j.transproceed.2016.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 07/28/2016] [Indexed: 10/20/2022]
|
38
|
Yazıcıoğlu A, Yekeler E, Yazıcı Ü, Aydın E, Taştepe R, Karaoğlanoğlu N. Management of Massive Hemoptysis: Analyses of 58 Patients. Turk Thorac J 2016. [DOI: 10.5578/ttj.30517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
39
|
Yazıcıoğlu A, Yekeler E, Yazıcı Ü, Aydın E, Taştepe İ, Karaoğlanoğlu N. Management of Massive Hemoptysis: Analyses of 58 Patients. Turk Thorac J 2016; 17:148-152. [PMID: 29404145 DOI: 10.5152/turkthoracj.2016.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 03/04/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The objective was to describe changing patterns of etiological factors and treatment modalities for massive hemoptysis. MATERIAL AND METHODS From January 2008-December 2012, the medical records of 58 massive hemoptysis patients were reviewed. RESULTS Fifty-eight patients, 44 were men (75.9%) and 14 were women (24.1%), with a mean age of 51.4 years (range= 19-84 years), were divided into three groups; surgical management (n= 37, 63.8%), conservative management (n= 14, 24.1%) and bronchial artery embolization (n= 6, 10.4%). One case (1.7%) had combined treatment modality; bronchial artery embolization was followed by surgical resection. Anatomical lung resections were the most preferred resection type in the surgical management group (n= 34, 91.9%). The most common etiological factor was bronchiectasis (n= 19, 32.8%); followed by bronchial cancer (n= 14, 24.1%). The duration of hospitalization in the surgical management group was 11.4 days (range= 4-24); whereas in the bronchial artery embolization group, hospitalization was only four days (range= 2-7) (p< 0.01). Prolonged air leak (n= 7; 18.9%) was the most common complication in the surgical management group. CONCLUSION We emphasize that bronchiectasis was leading cause of massive hemoptysis. Surgical treatment remains the definitive therapy in the management of massive hemoptysis with decreased mortality rates over decades; whereas bronchial artery embolization is an effective therapeutic tool.
Collapse
Affiliation(s)
- Alkın Yazıcıoğlu
- Clinic of Chest Surgery and Lung Transplantation, Türkiye High Specialization Training and Research Hospital, Ankara, Turkey
| | - Erdal Yekeler
- Clinic of Chest Surgery and Lung Transplantation, Türkiye High Specialization Training and Research Hospital, Ankara, Turkey
| | - Ülkü Yazıcı
- Clinic of Chest Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ertan Aydın
- Clinic of Chest Surgery, Koru Private Hospital, Ankara, Turkey
| | - İrfan Taştepe
- Department of Chest Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Nurettin Karaoğlanoğlu
- Clinic of Chest Surgery, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
40
|
Yazicioglu A, Turkkan S, Subasi M, Basaran F, Boztepe H, Demirag F, Yekeler E. P-264DOES PULMONARY LANGERHANS' CELL HISTIOCYTOSIS HAVE A RECURRENCE PATTERN AFTER LUNG TRANSPLANTATION? Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
41
|
Yekeler E, Yazicioglu A, Subasi M, Boztepe H. Giant Esophageal Lipoma as an Uncommon Cause of Diverticula. Case Rep Gastroenterol 2016; 10:446-451. [PMID: 27721731 PMCID: PMC5043252 DOI: 10.1159/000447487] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 12/21/2022] Open
Abstract
Esophageal lipoma is an uncommon benign tumor of the esophagus and accounts for only 0.4% of all benign neoplasms of the gastrointestinal system. The majority of these are located in the cervical part; only very few are located in the lower third of the esophagus. We discuss the case of a 37-year-old female who presented with dysphagia and an esophageal lipoma located in the lower third of the esophagus. The patient underwent right mini-thoracotomy and enucleation of lipoma. Histopathologic examination revealed adipose tissue with a collection of matured adipose tissue. We present the case because of the atypical localization of an esophageal lipoma and development of a diverticulum, which was caused by the lipoma and required an additional surgical procedure.
Collapse
Affiliation(s)
- Erdal Yekeler
- Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Thoracic Surgery and Lung Transplantation, Ankara, Turkey
| | - Alkin Yazicioglu
- Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Thoracic Surgery and Lung Transplantation, Ankara, Turkey
| | - Mahmut Subasi
- Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Thoracic Surgery and Lung Transplantation, Ankara, Turkey
| | - Hacer Boztepe
- Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Thoracic Surgery and Lung Transplantation, Ankara, Turkey
| |
Collapse
|
42
|
Yazicioglu A, Alici IO, Karaoglanoglu N, Yekeler E. Pitfalls and Challenges of Lung Transplant in a Patient With Kartagener Syndrome and Scoliosis. EXP CLIN TRANSPLANT 2016; 16:237-241. [PMID: 26976528 DOI: 10.6002/ect.2015.0190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We present a 22-year-old woman with Kartagener syndrome and scoliosis who died 112 days after single lung transplant. The classic thoracic involvement of situs inversus totalis and the asymmetric arrangement of the thoracic vascular structures might be a pitfall for surgeon. Anatomic obstacles have forced the surgeon to perform a single transplant. The period of primary graft dysfunction in a single transplanted lung patient was a challenge; supporting the patient with a high flow and long period of extracorporeal membrane oxygenation might lead to a vanishing bronchus. Immotile cilia, a feature of Kartagener syndrome, were another challenge and patient needed several daily aspiration bronchoscopies. Vanishing bronchus is a gradual process with high mortality rates; commonly, stenosis is at the non anastomotic bronchial tree because of insufficient nourishment of the bronchial cartilages. Several repeat bronchoscopic balloon dilatations accompanied with medical treatment were unsuccessful.
Collapse
Affiliation(s)
- Alkin Yazicioglu
- From the Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| | | | | | | |
Collapse
|
43
|
Alici IO, Yekeler E, Yazicioglu A, Turan S, Tezer-Tekce Y, Demirag F, Karaoglanoglu N. A case of acute fibrinous and organizing pneumonia during early postoperative period after lung transplantation. Transplant Proc 2016; 47:836-40. [PMID: 25891742 DOI: 10.1016/j.transproceed.2015.02.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 01/15/2015] [Accepted: 02/09/2015] [Indexed: 01/16/2023]
Abstract
Acute fibrinous and organizing pneumonia (AFOP) is a distinct histologic pattern usually classified under the term chronic lung allograft dysfunction. We present a 48-year-old female patient who experienced AFOP during the 2nd week of double lung transplantation for pulmonary Langerhans cell histiocytosis and secondary pulmonary hypertension. During the 8th day after transplantation, fever and neutrophilia developed together with bilateral consolidation. Infection markers were elevated. Despite coverage of a full antimicrobial spectrum, the situation progressed. The patient was diagnosed with AFOP with transbronchial biopsy. The infiltration resolved and the patient improved dramatically with the initiation of pulse corticosteroid treatment. AFOP should be suspected when there is a pulmonary consolidation after lung transplantation, even in the very early post-transplantation period. Several causes, such as alveolar damage and drug reactions, should be considered in the differential diagnosis.
Collapse
Affiliation(s)
- I O Alici
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
| | - E Yekeler
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - A Yazicioglu
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - S Turan
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Y Tezer-Tekce
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - F Demirag
- Department of Pathology, Ataturk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey
| | - N Karaoglanoglu
- Thoracic Surgery and Lung Transplantation Center, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| |
Collapse
|
44
|
Yekeler E, Yazicioglu A, Karaoglanoglu N. Gastroid Achalasia. Electron J Gen Med 2016. [DOI: 10.15197/ejgm.01404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
45
|
Demirag F, Alici I, Yekeler E, Karaoglanoglu N, Yazicioglu A. Can Sericin Prove Useful as a Pleurodesis Agent or Tissue Glue? Thorac Cardiovasc Surg 2016; 65:367-374. [DOI: 10.1055/s-0035-1570373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background Sericin is a natural, gum-like, macromolecule protein, synthesized from silkworms for the formation of cocoon shells. The aim of the present study is to describe the effects of sericin when used for pleurodesis and/or as tissue glue.
Methods Adult, male, 12-week-old Wistar albino rats, weighing 257 to 395 g were used in the present study (n = 12). The animals were randomly divided into two equal groups as the sericin and the control group. After intramuscular administration of the anesthetic agent, the rats were intubated and mechanically ventilated. A left thoracotomy was performed and 30 mg sericin powder was instilled into the thoraxes of the sericin group. The remaining rats were allocated to a sham thoracotomy group. The animals were housed in individual cages, fed ad-libitum, and sacrificed 8 days after. After sacrifice, the left hemithoraxes were removed en bloc and underwent histopathologic examination.
Results Masson trichrome staining was applied on the visceral pleura sections of all the animals. Each animal specimen (n = 6, 100%) in the control group showed minimal collagen deposition, while only one rat (16.67%) in the sericin group had minimal collagen deposition. However, in the sericin group, five animals (83.33%) showed dense collagen deposition, fibroblastic activity, and fibrosis. According to the test method, independent t-test, developing fibroblastic activity and fibrosis are statistically significant between the two groups (p < 0.01). There were no foreign-body reactions and no evidence of biological glue on the specimens in the sericin group. The rats in the sericin group had lower inflammatory reactions compared with those in the control group. Emphysema was observed in two rats (33.33%) in the sericin group and in four rats (66.67%) in the control group. Therefore, sericin was found to be associated with an increase in fibroblastic activity and fibrosis in visceral pleura without exerting any adverse effect on the lung parenchyma.
Conclusion Sericin is a new and researchable protein for chest diseases and thoracic surgery. To develop an effect of dense collagen deposition, fibroblastic activity, and fibrosis in the visceral pleura, without significant adverse effects, is remarkable. Therefore, sericin may be useful as a pleurodesis agent or natural biological glue in the future. Sericin treatment can add value to the disciplines of pulmonology and thoracic surgery.
Collapse
Affiliation(s)
- Funda Demirag
- Department of Pathology, Ataturk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Ibrahim Alici
- Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| | - Erdal Yekeler
- Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| | - Nurettin Karaoglanoglu
- Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| | - Alkin Yazicioglu
- Turkiye Yuksek Ihtisas Training and Research Hospital, Thoracic Surgery and Lung Transplantation Clinic, Ankara, Turkey
| |
Collapse
|
46
|
Yazicioglu A, Alici I, Turan S, Yazicioglu H, Demirag F, Karaoglanoglu N, Yekeler E. P-289THE CHALLENGES OF LUNG TRANSPLANTATION IN A PATIENT WITH KARTAGENER SYNDROME AND SCOLIOSIS. Interact Cardiovasc Thorac Surg 2015. [DOI: 10.1093/icvts/ivv204.289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
47
|
Abstract
Calcified fibrous pseudotumors can generally be detected as solitary masses in various regions of the body, and were first described in 1988. In this case report, we discuss an adult patient whose tumor was localized in the lung, which has not been reported in the literature before.
Collapse
|
48
|
Alici I, Yekeler E, Yazicioglu A, Turan S, Tezer-Tekce Y, Demirag F, Karaoglanoglu N. P-228 * A CASE OF ACUTE FIBRINOUS AND ORGANIZING PNEUMONIA DURING EARLY POSTOPERATIVE PERIOD AFTER LUNG TRANSPLANTATION. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
49
|
Yahyayev A, Bulakci M, Yilmaz E, Ucar A, Sayin OA, Yekeler E. Absence of the right iliac vein and an unusual connection between both common femoral veins. Phlebology 2014; 28:162-4. [PMID: 22431769 DOI: 10.1258/phleb.2011.011080] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study is to report a case of a rare congenital anomaly of the venous system and to emphasize its clinical importance. We describe a case of aplasia of the right common and external iliac veins in a healthy seven-year-old boy who was referred for Doppler ultrasound examination for further evaluation of an abnormal varicosity in the suprapubic region. Colour Doppler ultrasound revealed a dilated, arch-shaped vein. Contrast-enhanced magnetic resonance angiography showed the absence of the right common iliac vein and external iliac vein. It also clearly demonstrated the aberrant venous structure, originating from the right common femoral vein and draining to the left common femoral vein. In conclusion, in our case, the patient’s life was threatened because the aberrant venous connection crossing within subcutaneous fatty tissue was not protected from external trauma and possible abdominal surgical interventions. Additional attention should be given to avoid such injuries, which can cause significant haemorrhage.
Collapse
Affiliation(s)
- A Yahyayev
- Radiology Department, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
50
|
Koksal D, Demirag F, Bayiz H, Ozmen O, Tatci E, Berktas B, Aydoğdu K, Yekeler E. The correlation of SUVmax with pathological characteristics of primary tumor and the value of Tumor/ Lymph node SUVmax ratio for predicting metastasis to lymph nodes in resected NSCLC patients. J Cardiothorac Surg 2013; 8:63. [PMID: 23557204 PMCID: PMC3622559 DOI: 10.1186/1749-8090-8-63] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 03/26/2013] [Indexed: 12/25/2022] Open
Abstract
Background We aimed to investigate the correlation of maximum standardized uptake value (SUVmax) with pathological characteristics of primary tumor and to determine a Tumor/ Lymph node (T/LN) SUVmax ratio predicting metastasis to lymph nodes in NSCLC patients. Methods Eighty-one NSCLC patients who had PET/CT examination at initial staging and subsequently underwent surgical resection were retrospectively evaluated. There were 100 PET/CT positive mediastinal or hilar lymph node stations. Pathological characteristics of the tumor such as largest tumor diameter, tumor histology, differentiation, number of mitosis, degree of stromal inflammation, necrosis; etiology of PET/CT positive lymph node stations; SUVmax of primary tumor and positive lymph node stations were recorded. A T/LN SUVmax ratio was calculated for each lymph node station. Results SUVmax of the primary tumor was positively correlated with the largest tumor diameter (p = 0.001, r = 0.374), number of mitosis (p < 0.001, r = 0.405), and postoperative pathological stage (p = 0.007, r = 0.298). Patients with squamous cell carcinoma had a statistically significant higher mean SUVmax, number of mitosis and advanced N stages compared to adenocarcinoma. The etiology of 100 PET/CT positive lymph node stations were metastasis in 14, anthracosis in 40, reactive in 39, granulomatous in 4, and silicosis in 3 patients. A T/LN SUVmax ratio of 5 or lower was suggestive for a malignant lymph node with a sensitivity of 92.8% and specificity of 47%. Conclusions SUVmax of a primary tumor is related to certain pathological characteristics, such as largest diameter, histology, and number of mitosis. A T/LN SUVmax ratio lower than 5 predicts the metastasis to lymph nodes with a high sensitivity.
Collapse
Affiliation(s)
- Deniz Koksal
- Chest Diseases Clinic, Ataturk Chest Diseases and Chest Surgery Education and Research Hospital, Ankara, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|