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Öğe Biosensing technologies applied in virus detection as rapid tools during pandemics: past lessons and recent trends(Elsevier, 2022) Moulahoum H.; Ghorbanizamani F.; Zihnioglu F.; Goksel T.; Turhan K.; Timur S.COVID-19 is the recent pandemic affecting the world population with millions of cases recorded to date. Although vaccines have been announced recently, their approval and widespread availability are still in nascent stages. Therefore, diagnostic testing remains critical for the control of the continuously increasing positive cases. Since the start, many approaches for rapid detection have been put up front as a first-line defense against the virus. Furthermore, advances in technology and the lessons learned from past virus outbreaks (such as SARS-CoV and MERS-CoV) have been helpful in the quick development of diagnostic tools. Biosensors played a major role in the fight against the COVID-19 virus. The use of nanomaterials enabled researchers to create highly sensitive tools that demonstrate precision, portability, and cost-effectiveness. This chapter summarizes the various advances in nanomaterials-enabled biosensors that were acquired from past pandemics or developed recently. © 2022 Elsevier Inc. All rights reserved.Öğe Diagnostic value of 18F-FDG-PET/CT in benign lung diseases(Termedia Publishing House Ltd., 2018) Ergonul A.G.; Akcam T.I.; Özdil A.; Turhan K.; Cakan A.; Cagirici U.Introduction: There are many diseases which, despite not being malignant, show high metabolic activity and cause falsepositive results. Aim: To evaluate the results of positron emission tomography (PET) in patients who underwent resection after preliminary diagnosis of malignancy based on fluorodeoxyglucose (FDG) uptake value, in whom the lesions were later classified as pathologically benign. Material and methods: The analysis included the records of 106 (12.3%) patients out of 862 patients who underwent surgery between January 2012 and December 2015 after being initially diagnosed with malignant lung lesions based on PETCT results, in whom the lesions were later classified as pathologically benign. Diagnoses, PET findings, types of surgery, and demographic data of the patients were recorded. Results: The mean age of the patients was 55.5 (26-79) years. The mean diameter and SUVmax of the lesions were 2 ±2.14 (0.5-13) and 3.55 ±4.35 (0-22.2) cm, respectively. The pathology results were analyzed in five different groups. The SUVmax in the hamartoma group was significantly lower than in the other groups (p < 0.001), while the SUVmax in the granulomatous disease group was significantly higher than in the other groups (p < 0.001). Conclusions: The possibility of false positive PET results must be kept in mind when diagnosing and treating lung cancer. In particular, in the case of suspected granulomatous disease, all available pre- and intraoperative diagnostic procedures must be used. © 2018 Termedia Publishing House Ltd. All Rights Reserved.Öğe The effect of blood vessel invasion on prognosis of operated stage i non-small cell lung cancer patients(2010) Turhan K.; Samancilar O.; Cagirici U.; Goksel T.; Nart D.; Cakan A.; Cok G.Objective: A retrospective study was conducted to identify the effect of blood vessel invasion on prognosis in surgically treated stage I non-small cell lung cancer patients. Methods: A total of 71 consecutive patients who had undergone complete resection for stage I primary non-small cell lung cancer (NSCLC) between 1998 and 2007 were evaluated. All pathological specimens were examined for evidence of blood vessel invasion. The follow-up period was 5118 months. Survival data were analyzed for all patients using the Kaplan-Meier test. Results: There were 63 men and 8 women (mean age 59.2, age range 3586). The most common tumor types were adenocarcinoma (35 patients, 49%) and squamous cell carcinoma (26 patients, 37%). Twenty-five patients (35%) had stage IA disease, and 46 had (65%) stage IB disease. In 13 cases (18%) blood vessel invasion was demonstrated, whereas in the remaining 58 cases there was no evidence of vascular invasion. Minimum and maximum follow-up periods were 5 and 118 months respectively, with a mean of 41.76±27 months (median 33.5 months). Overall disease-free survival was 79.6±6.4 months: 38.3±12.0 months for the group with blood vessel invasion and 87.5±6.7 months for the remaining group. The difference between the two groups was statistically significant (p<0.003). Overall survival rate was 86.7±6.7 months: 44.5±11.3 months for blood vessel invasion group and 98.2±6.2 months for the remaining group. The difference between the two groups was statistically significant (p<0.001). Conclusion: Vascular invasion can be an important factor for predicting unfavorable prognosis in stage I NSCLC patients. © Georg Thieme Verlag KG.Öğe Expectoration of tracheobronchial grass inflorescence mimicking a chest wall tumor [Göğüs Duvarı Tümörünü Taklit Eden Trakeobronşial Pisi Pisi Otunun Ekspektorasyonu](Derman Medical Publishing, 2016) Erol Y.; Ergönül A.G.; Turhan K.; Çağırıcı U.; Çakan A.In this case presentation, a 19-year-old male patient was examined because of complaints of right lateral chest swelling, lateral pain, and high fever at night. After a chest CT, the patient was directed to our clinic with a pre-diagnosis of chest wall tumor following the detection of peripheral consolidation concurrent with atelectasis in the lower lobe lateral basal segment in the right lung and a lesion with irregular contour in pleura and the thoracic wall, starting at this level and descending to the inferior. Because the symptoms pointed to infection, antibiotic therapy was started and a fine-needle aspiration biopsy was concur-rently performed. Results of the biopsy were reported as “suspicious cytology.” The patient, who responded to antibiotic therapy both clinically and radiologi-cally, expectorated a foreign body during monitoring. Pathological examination reported “in herbal quality, grass inflorescence” as the traits of the expectorated body. In the literature there are cases in which grass inflorescence, in accordance with its nature, passed distally out of the chest wall with migration following the aspiration. However, no other publication has reported an intriguing case such as ours, in which the grass inflorescence caused inflammation that mimicked a chest wall tumor and then was expectorated moving in the opposite direction. © 2016, Journal of Clinical and Analytical Medicine. All rights reserved.Öğe Incidence of post-thoracotomy chronic pain and its impact on quality of life [Posttorakotomi kronik agri{dotless} İnsidansi{dotless} ve yaşam kalitesi üzerine etkisi](Turkiye Klinikleri, 2013) YeşIldag C.; Erhan E.; DenIz M.N.; Çagrici U.; Çakan A.; Turhan K.; Yegül M.I.Objective: Chronic pain is common after thoracotomy. The goal of this study was to investigate the incidence of chronic post-thoracotomy pain and its impact on quality of life. Material and Methods: Two hundred and thirty three patients who had undergone a classic postero-lateral thoracotomy in our institution between January 2007 and October 2009 were evaluated. Patients who had more than one operation or died during follow up were excluded. All patients were contacted by telephone and were questioned about the presence of post-thoracotomy pain. Patients who had post-thoracotomy pain were invited for face to face interview with a Pain Questionnaire Form. Results: Seventy four patients were excluded from the study. One hundred twelve out of 159 patients were contacted by telephone. The incidence of chronic post-thoracotomy pain was 56%. Pain Questionnaire revealed that 69.4% of the patients had mild, 26.5% had moderate and 4.1% had severe chronic pain. Thirty-nine percent of the patients with pain needed analgesia, 24% felt their pain was their worst medical problem and 24% reported that it limited their daily activities. The prevalence of each neuropathic symptom was between 4% and 61%. Conclusion: Our study confirms that chronic post-thoracotomy pain is a common problem. About 30.6% of patients have moderate to severe chronic post-thoracotomy pain affecting their quality of life. © 2013 by Türkiye Klinikleri.Öğe Inhibition of cardiac Ca2+ release channels (RyR2) determines efficacy of class i antiarrhythmic drugs in catecholaminergic polymorphic ventricular tachycardia(2011) Hwang H.S.; Hasdemir C.; Laver D.; Mehra D.; Turhan K.; Faggioni M.; Yin H.; Knollmann B.C.Background-Catecholaminergic polymorphic ventricular tachycardia (CPVT) is caused by mutations in the cardiac ryanodine receptor (RyR2) or calsequestrin (Casq2) and can be difficult to treat. The class Ic antiarrhythmic drug flecainide blocks RyR2 channels and prevents CPVT in mice and humans. It is not known whether other class I antiarrhythmic drugs also block RyR2 channels and to what extent RyR2 channel inhibition contributes to antiarrhythmic efficacy in CPVT. Methods and Results-We first measured the effect of all class I antiarrhythmic drugs marketed in the United States (quinidine, procainamide, disopyramide, lidocaine, mexiletine, flecainide, and propafenone) on single RyR2 channels incorporated into lipid bilayers. Only flecainide and propafenone inhibited RyR2 channels, with the S-enantiomer of propafenone having a significantly lower potency than R-propafenone or flecainide. In Casq2 -/- myocytes, the propafenone enantiomers and flecainide significantly reduced arrhythmogenic Ca2+ waves at clinically relevant concentrations, whereas Na+ channel inhibitors without RyR2 blocking properties did not. In Casq2-/- mice, 5 mg/kg R-propafenone or 20 mg/kg S-propafenone prevented exercise-induced CPVT, whereas procainamide (20 mg/kg) or lidocaine (20 mg/kg) were ineffective (=5 to 9 mice, P<0.05). QRS duration was not significantly different, indicating a similar degree of Na= channel inhibition. Clinically, propafenone (900 mg/d) prevented ICD shocks in a 22-year-old CPVT patient who had been refractory to maximal standard drug therapy and bilateral stellate ganglionectomy. Conclusions-RyR2 cardiac Ca2 + release channel inhibition appears to determine efficacy of class I drugs for the prevention of CPVT in Casq2-/- mice. Propafenone may be an alternative to flecainide for CPVT patients symptomatic on ß-blockers. © 2011 American Heart Association, Inc.Öğe A life-saving approach after thoracic trauma: Emergency room thoracotomy [Toraks travmasi{dotless} sonrasi{dotless} hayat kurtari{dotless}ci{dotless} bir uygulama: Acil serviste torakotomi](2012) Akçam T.I.; Turhan K.; Ergönül A.G.; Oguz E.; Çakan A.; Çagirici U.BACKGROUND In this article, the outcomes, indications and methods of emergency department service resuscitative thoracotomy in cardiac and/or respiratory arrest patients after thoracic trauma are discussed. METHODS Between January 2004 and December 2010, nine resuscitative thoracotomies were performed after thoracic trauma in the emergency department of our hospital. The records of the patients were evaluated retrospectively. RESULTS A total of nine patients underwent resuscitative thoracotomy: five stab wounds, two traffic accidents, one fall from height, and one gunshot wound. Anterolateral thoracotomy in supine position was performed in all. Three patients had lung parenchymal laceration, three patients had cardiac laceration, two patients had intercostal vessel injury, and one patient had descending aorta injury. None of the four patients with blunt trauma recovered. Three of five patients with penetrating trauma were discharged after an average of eight days of follow-up, whereas two of them were lost perioperatively. CONCLUSION Emergency room thoracotomy can be performed in thoracic trauma cases who are in shock and have unresponsive hypotension despite large volume fluid and blood replacement and no time for transportation to the operating room. The results are better in penetrating trauma patients than in blunt trauma.Öğe Ligasure vessel sealing system versus harmonic scalpel for sutureless nonanatomical pulmonary resections in a rabbit model: Which one is safer?(2009) Cakan A.; Yoldas B.; Samancilar O.; Ertugrul V.; Turhan K.; Cagirici U.; Askar F.; Veral A.Background: The safety and efficacy of the ligasure vessel sealing system (LVSS) and harmonic scalpel (HS) in sutureless nonanatomical lung resections were evaluated. Methods: On twenty adult rabbit lungs, 1 × 1 cm wedge resections were performed under one-lung ventilation with both LVSS and HS. The air tightness and tissue damage caused by these different techniques were measured and compared. Results: No statistically significant differences were found when the air tightness for both devices was compared after resection (p = 0.37). Tissue damage was obtained for LVSS, and the difference was statistically significant (p < 0.001). Discussion: LVSS and HS can both be used for peripheral lung resections without any need of further intervention for securing the air tightness. LVSS was found safer by means of tissue damage when compared with HS in this experimental study. © 2009 S. Karger AG, Basel.Öğe Minimally invasive surgery for descending necrotizing mediastinitis(2010) Turhan K.; Samancilar Ö.; Çakan A.; Çagirici U.Descending necrotizing mediastinitis (DNM) is a lethal disease with a high mortality rate, and occurs as a complication of odontogenical or cervical infections. The choice of treatment is still controversial and ranges from a cervical approach alone to cervical approach with clamshell incision. Until now, there have been only a few cases operated on via thoracoscopy in the literature. In this study, we present a 21 year-old man who was referred with high fever and neck swelling after the removal of an infected right lower second molar tooth, and diagnosed as DNM, and succesfully treated with cervical and unilateral videothoracoscopic approach.Öğe Myasthenia gravis with thymoma: Histopathologic examination and rate of complication After Surgery [Myasthenia Gravis Timoma Birlikteligi: Histopatolojik i·nceleme ve cerrahi sonrasi{dotless} komplikasyon oranlari{dotless}ni{dotless}n degerlendirilmesi](2011) Çevik A.G.; Turhan K.; Çakan A.; Özdil A.; Çagirici U.Aim It is known that thymus and thymoma have a role in the etiopathogenesis of myasthenia gravis (MG). These associations and their effects on the survival have investigated in several studies since 17th century. The incidence of MG in patients with thymoma was reported to be 20-50% in different studies. The aim of this study is to investigate the relationship between thymoma and MG and to evaluate the rates of postoperative complications. Material and Methods The study included 25 patients (13 female and 12 male) and the mean age of patients was 42.3 years (range 24 to 70 years). 11 (44%) of patients had been treated with the diagnosis of MG. Eight (57%) of 14 (56%) patients without the diagnosis of MG had no symptoms and thymoma was detected accidentaly. The common symptom of the other 6 (43%) patients was cough. 9 (36%) patients were staged according to WHO classification. The other patients could not be staged according to WHO classification; because they were operated before the year of 2001. Four of patients were stage B1, 2 were stage B2, 2 were stage B3 and 1 was stage AB. Postoperative complication occured in 4 (16%) patients. Results MG was seen with a higher rate in cortical thymoma when compared with medullary thymoma, in immunohistochemical investigations. MG had been thought as a negative prognostic factor for thymoma but in the last years it had been reported as a positive prognostic factor due to the development of postoperative intensive care conditions, medical therapy and follow up.Öğe A new algorithm for preoperative cardiac assessment in patients undergoing pulmonary resection(2005) Cagirici U.; Nalbantgil S.; Cakan A.; Turhan K.From January 2001 through June 2002, 128 consecutive patients undergoing lung resection for various diseases were evaluated preoperatively by a cardiologist at our institution in order to predict postoperative cardiac complications in pulmonary surgery. Our assessment algorithm consisted of the following: Smoking, hypertension, hyperlipidemia, advanced age, diabetes mellitus, and history of cardiac disease or angina pectoris were considered as risk factors. A stress test was performed when at least 2 of the first 3 risk factors or at least 1 of the last 3 risk factors was present. Coronary angiography was performed in the case of a positive stress test. Patients were classified as low-risk when there was no need for a stress test. Patients were considered as intermediate-risk when a stress test revealed no ischemia or if there was a history of congestive heart failure or valvular disease. Patients in whom coronary artery disease was detected on angiography were classified as high-risk. Ninety-five of our patients were in the low-risk group, and 29 were in the intermediate-risk group. After lung resection, cardiac complications developed in 4 patients in the low-risk group (atrial fibrillation) and in 8 patients in the intermediate-risk group (5 atrial fibrillation and 3 paroxysmal atrial tachycardia). The overall cardiac complication rate was 9.7%. No death occurred due to cardiac events. The difference in the incidence of arrhythmias between the low- and the intermediate-risk groups was significant (P <0.05). We present this simple algorithm for preoperative cardiac evaluation in patients scheduled to undergo lung resection, and we suggest that it may be possible to predict post-operative cardiac complications with this method. © 2005 by the Texas Heart® Institute.Öğe One case, two "firsts": First successful double lung and first pediatric lung transplantation in Turkey [Bir olgu, iki ilk: Türkiye'de ilk başarili çift akciger transplantasyonu; pediatrik yaş grubunda Türkiye'de ilk akciger transplantasyonu](2010) Özbaran M.; Turhan K.; Yagdi T.; Gülen F.; Özcan C.; Engin Ç.; Midyat L.; Çagirici U.; Nart D.; Nalbantgil S.; Demir E.; Tanaç R.; Aşkar F.We report the first successful double-lung transplantation in all age groups as well as the first lung transplantation in the pediatric age group in our country. A 14-year-old male who was oxygen dependent for the last three years was diagnosed with septic lung disease and bronchiolitis obliterans. He was followed-up by the "heart and lung transplantation group" of our hospital for approximately one year under non-invasive mechanical ventilatory support while on the lung transplantation waiting list. A sequential double lung transplantation was performed on April 08, 2009. He is now on his 11th month postoperatively and is healthy.Öğe Psychiatric assessments in patients operated on due to lung cancer(SAGE Publications Inc., 2017) Erol Y.; Çakan A.; Ergönül A.G.; Sertöz Ö.; Özdil A.; Turhan K.; Çagirici U.Background This study was undertaken to determine the relationship between preoperative and postoperative psychiatric status and postoperative complications in patients operated on due to lung cancer. Methods We prospectively enrolled 25 patients undergoing surgery with a diagnosis of lung cancer. There were 17 (68%) males, 8 (32%) females, and the mean age was 61 ± 8.9 years (range 38-81 years). Their psychiatric status was assessed using the Experiences in Close Relationships Scale II, European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30, Perceived Family Support Scale, the combined Stress Thermometer and Hospital Anxiety Depression Scale, in the preoperative period, and the Perceived Family Support, Stress Thermometer, and European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 at 1 month postoperatively. Results We found that 44% of patients had depression and 28% had anxiety. There was no difference between sexes in terms of anxiety (p = 0.088), but more women had depression (p = 0.03). Postoperative complications occurred in 5 of 18 patients with negligible anxiety scores (27.8%) and 3 (42.9%) of 7 patients with high scores, as well as 3 (21.4%) patients with negligible depression scores and 5 (45.5%) of 11 patients with high scores. Conclusions Patients selected for lung cancer surgery should be assessed preoperatively using the Hospital Anxiety-Depression Scale and Stress Thermometer. Psychosocial support is recommended to improve their quality of life and reduce postoperative complications. © SAGE Publications.Öğe The psychiatric follow-up process of a lung transplantation case [Bir akciger nakli olgusunda psikiyatrik izlem süreci](2010) Özbaran B.; Erermiş S.; Gülen F.; Midyat L.; Turhan K.; Demir E.; Yagdi T.; Tanaç R.; Özcan C.; Engin Ç.; Özbaran M.Organ transplantation practices are increasing worldwide and in our country and patient care opportunities are improving. Organ transplantation process generally includes transplant preparation, coping with disease, transplantation operation and post-transplantation period. Psychiatrists take part in the transplantation team and support the team and the patient, offer treatment if necessary. In this report the psychiatric symptoms and treatment of the first living pediatric case after double lung transplantation were reported. The fifteen years old, male case was followed since age of fourteen in Ege University Medical School Pediatrics Clinic, Respiratory System and Allergy Department with diagnoses of bronchiolitis obliterans, bronchiectasis and pulmonary hypertension and indicated double lung transplantation in year of 2008. In April 2009, the first double lung transplantation surgery in Turkey in pediatric age group was done. In 15th day after transplantation anxiety symptoms were occurred and these symptoms were limited and disappeared with brief supportive interventions. In fifth month after transplantation depressive symptoms were occurred and the case was diagnosed as depressive disorder and treated with fluoxetin 20 mg/day. Psychosocial interventions were also undertaken for his edu-education. The case is still in follow-up in Ege University Child Psychiatry Clinic, Consultation Liaison Department.Öğe Quantitative measurement of air leak in patients with chest drains [Göğüs tüpü bulunan hastalarda hava kaçağinin kantitatif ölçümü](Baycinar Medical Publishing, 2019) Kavurmaci Ö.; Çağirici U.; Akçam T.; Özdil A.; Ergönül A.G.; Turhan K.; çakan A.Background: This study aims to evaluate a new method that detects peak air leak speed and peak air leak flow, investigate the correlation between the amount of air leak and development of prolonged air leak, and identify patients who are at risk of developing prolonged air leak after lung resection. Methods: In this prospective trial, the amount of air leak was measured with the assistance of an anemometer connected to the top of a standard underwater drainage system, and a mobile phone with android operating system. Patients who underwent tube thoracostomy for spontaneous pneumothorax were assigned to group 1 (18 males, 1 female; mean age 31.6±10.9 years; range, 18 to 70 years), whereas patients who underwent lung resection for benign or malignant lung diseases were assigned to group 2 (37 males; 16 females; mean age 56.9±15.6 years; range, 18 to 80 years). The receiver operating characteristics analysis was performed for the statistical analysis of the data. Results: Prolonged air leak was observed in five patients (26.3%) in group 1 and in six patients (11.3%) in group 2. In group 1, first measurement on postoperative day zero could detect prolonged air leak development with 100% sensitivity and 92.9% specificity. Similarly, in group 2, measurements on day zero could detect prolonged air leak development with 100% sensitivity and 87.2% specificity. Conclusion: Compared to similar products, this newly developed measuring device may be widely used in clinics with its low cost and ease of use. Measured peak air leak flow values can predict patients who may develop prolonged air leak. Patent work for the device is ongoing. © 2019 by the Turkish Society of Cardiovascular Surgery.Amaç: Bu çalişmada tepe hava kaçak hizini ve tepe hava kaçak debisini saptayan yeni bir yöntem değerlendirildi, hava kaçaği miktari ve uzamiş hava kaçaği gelişimi arasindaki ilişki araştirildi ve akciğer rezeksiyonu sonrasi uzamiş hava kaçaği gelişimi riski taşiyan hastalar belirlendi. çalişma plani: Bu prospektif çalişmada, hava kaçaği miktari standart bir su alti drenaj sisteminin üstüne bağli bir anemometre ve android işletim sistemine sahip bir cep telefonu yardimi ile ölçüldü. Spontan pnömotoraks için tüp torakostomi uygulanan hastalar (18 erkek, 1 kadin; ort. yaş 31.6±10.9 yil; dağilim, 18-70 yil) grup 1'e, benign veya malign akciğer hastaliklari nedeniyle akciğer rezeksiyonu uygulanan hastalar (37 erkek; 16 kadin; ort. yaş 56.9±15.6 yil; dağilim, 18-80 yil) ise grup 2'ye alindi. Verilerin istatistiksel analizi için alici işletim karakteristiği analizi uygulandi. Bulgular: Uzamiş hava kaçaği grup 1'de beş hastada (%26.3), grup 2'de alti hastada (%11.3) gözlemlendi. Grup 1'de, ameliyat sonrasi sifirinci gündeki ilk ölçüm uzamiş hava kaçaği gelişimini %100 duyarlilik ve %92.9 özgüllük ile saptayabildi. Benzer şekilde, grup 2'de, ameliyat sonrasi sifirinci gündeki ölçümler uzamiş hava kaçaği gelişimini %100 duyarlilik ve %87.2 özgüllük ile saptayabildi. Sonuç: Benzer ürünler ile karşilaştirildiğinda, yeni geliştirilen bu ölçüm cihazi düşük maliyeti ve kullanim kolayliği ile kliniklerde yaygin şekilde kullanilabilir. ölçülen tepe hava kaçak debisi değerleri uzamiş hava kaçaği gelişebilecek hastalari öngörebilir. Cihaz için patent çalişmalari devam etmektedir. © 2019 by the Turkish Society of Cardiovascular Surgery.Öğe Reply to Khalil and Sarkar(2008) Turhan K.; Makay O.; Firat O.; Samancilar O.[No abstract available]Öğe Results of surgical treatment for lung cancer in advanced age [Ileri yaş akciger kanserinde cerrahi tedavi sonuçlari.](2003) Cagirici U.; Turhan K.; Göksel T.; Posacioglu H.; Veral A.; Bilkay O.In this study, 24 patients aged 70 and over who were operated for primary bronchogenic carcinoma were reviewed retrospectively and their results were compared with those of 90 patients under 70, whom operated for the same intent. The mean age and age range of the group were 74.6 +/- 3.3 and 70-86, respectively, and it consisted of 21 male and three female patients. The histology of the tumor revealed epidermoid carcinoma in 16 (67%) patients, adenocarcinoma in 6 (25%), and large cell carcinoma in 2 (8%). Twelve of the elderly patients had associated diseases (six had coronary artery disease and/or hypertension, four had chronic obstructive pulmonary disease and two had diabetes) that increased the operative risk. The resection type used most frequently was lobectomy (67%), followed by limited resection (25%). In postoperative staging, nine patients were found to have stage I disease, nine stage II disease, four stage IIIA disease and two stage IIIB disease. Three (13%) patients developed major complications, and postoperative mortality rate within 30 days was 4% with one patient. In the patients aged under 70, the last two variables were noted in 10 (%11) cases and in 1 (%1) case respectively, and the difference between the two groups was statistically insignificant. As a result, with appropriate patient selection and vigorous postoperative care, morbidity and mortality of the pulmonary resections in elderly is not higher than in young patients, and a curative resection should be preferred.Öğe Suppression of Damping off on Pepper Caused by Pythium ultimum Trow and Rhizoctonia solani Kühn by Some New Antagonists in Comparison with Trichoderma harzianum Rifai(1989) Turhan G.; Turhan K.Pot experiments were designed to evaluate the efficacy of Streptomyces nobilis, S. ochraceiscleroticus, Neocosmospora vasmfecta var. Africana and Acrophialophora levis isolates in reducing the damping-off on pepper in comparison with a strong mycoparasitic isolate of Trichoderma harzianum. Two pathogenic and five potential antagonistic isolates were grown seperately m flasks containing a mixture of sand-perlite-corn meal and potato-sucrose broth for 4 weeks. Soil infestation was achieved by mixing these stock cultures separately into the pot soils. Disease incidence was expressed as the percentages of dead seedlings in each pot and the protective values of the antagonists were calculated according to Abbott formula. Results indicated that all of the five test isolates have provided the seedhngs with protection of statistical value against Pythium uhimum and Rhizocionia solani reducing disease incidence between 28.14 to 79.14 % and 22.76 to 66.83 %, respectively. However, T. harzianum isolate proved to be the least effective antagonist against both pathogens. Copyright © 1989, Wiley Blackwell. All rights reservedÖğe Thoracic paravertebral block versus intrathecal morphine for pain relief after thoracotomy [Torakotomi sonrasi a?ri kontrolünde torasik paravertebral blok ile intratekal morfin uygulamalarlnin karşilaştirilmasi](Anestezi Dergisi, 2015) Kocabaş S.; Sergin D.; Aşkar F.Z.; Çetin Y.; Özbilgin Ş.; Turhan K.Objective: This study aimed to compare the analgesic efficacies of thoracic paravertebral block and intrathecal morphine in patients undergoing posterolateral thoracotomy and lobectomy under general anesthesia. Method: Forty patients, aged 18-65 yrs, undergoing elective lobectomies were randomized into two groups: In the paravertebral block group (PVB, n=20), an epidural catheter was inserted into the paravertebral space by the surgeon before thoracotomy closure; 20 mL 0.25% bupivacaine bolus was given at the end of surgery and 0.25% bupivacaine (0.1 mLkg-1h-1) infusion was given for 24th hour after surgery. In the intrathecal morphine group (UM, n=20), intrathecal 10 µg kg-1 morphine was given at the end of surgery. Patient controlled analgesia using morphine was administered postoperatively for all patients. Systolic and diastolic arterial pressures, heart rate, respiratory rate, oxygen saturation, arterial blood gases, peak expiratory flows and sedation scores were recorded. Results: Demographic data and postoperative hemodynamic, respiratory parameters and pain scores were similar in both groups. Postoperative 24th hour morphine consumption and sedation scores during the initial 4th hour after surgery were higher in the ITM group (p< 0.05), while sedation scores at 12th and 24th hour were similar between groups. Conclusion: Although both techniques were effective in controlling pain after posterolateral thoracotomy, morphine consumption at 24th hour was lower and sedation scores during the initial 4th hour after surgery were improved in patients who were administered a thoracic paravertebral block when compared to patients who were given intrathecal morphine.Öğe Traumatic diaphragmatic rupture: look to see(2008) Turhan K.; Makay O.; Cakan A.; Samancilar O.; Firat O.; Icoz G.; Cagirici U.Objective: Traumatic diaphragmatic rupture (TDR) is a rare but potentially life threatening clinical entity with a high incidence of associated injuries. In this article, our experience with this challenging diagnosis is presented. Methods: In this study, a total of 68 patients with TDR, were operated in our center between July 1994 and September 2005. Study group was analyzed retrospectively. The etiological factors, management and outcomes were discussed. Results: The mean age was 32.9 years with a female to male ratio of 9/59. TDR was right-sided in 16.2% (n = 11) and left-sided in 83.8% (n = 57). The cause of the rupture was penetrating trauma in 51 (75%), and blunt trauma in 17 (25%). Only three patients (4.4%) had late diagnosis. Associated injuries were seen in 91% (n = 62) of the patients. The most common used incision was a laparotomy incision (89.6%). Morbidity and mortality were encountered in 13.1% (n = 9) and 16.2% (n = 11) patients, respectively. Conclusions: Although rare, diaphragmatic rupture must be suspected in any patient with thoracoabdominal injury. Early diagnosis of TDR is sometimes difficult and depends on a high index of suspicion. Surgical repair is necessary even for small tears. The most common approach is the transabdominal approach, which allows a complete exploration of the abdominal organs for associated injuries. The transthoracic approach might be used in most cases with latent diaphragmatic rupture. © 2008 European Association for Cardio-Thoracic Surgery.
