Publications by authors named "Guven Olgac"

15 Publications

  • Page 1 of 1

COVID-19 pneumonia following double-sleeve lobectomy for lung cancer.

Gen Thorac Cardiovasc Surg 2021 Mar 30;69(3):577-579. Epub 2020 Sep 30.

Department of Thoracic Surgery, Bahcesehir University School of Medicine, Merdivenköy, 23 Nisan Sok. No:17, Kadıköy, 34732, Istanbul, Turkey.

Here, we report a 54-year-old man who underwent double-sleeve left upper lobectomy for lung cancer and his postoperative course was complicated with COVID-19 pneumonia. Five days after his discharge from hospital, he was re-admitted with mild fever and bilateral multiple ground glass opacities on his chest CT. PCR testing confirmed COVID-19 infection and he was treated according to policies established by our nation's health authority. He is still receiving adjuvant chemotherapy and remains well at 3 months after the operation.
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http://dx.doi.org/10.1007/s11748-020-01500-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7524866PMC
March 2021

The fate of microplastics during uptake and depuration phases in a blue mussel exposure system.

Environ Toxicol Chem 2019 01 29;38(1):99-105. Epub 2018 Nov 29.

Department of Environmental Engineering, Technical University of Denmark, Bygningstorvet, Kongens Lyngby, Denmark.

We present a blue mussel exposure system where the fate of microplastics (polystyrene beads) is tracked during exposure and depuration phases. This enabled the establishment of a complete mass balance. Quantification of beads in mussels was done with a novel enzymatic digestion protocol. We found a similar relative distribution of beads for 2 environmentally realistic concentrations (5 and 100 beads L ) and no substantial egestion of particles within 2 h of depuration. Environ Toxicol Chem 2019;38:99-105. © 2018 SETAC.
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http://dx.doi.org/10.1002/etc.4285DOI Listing
January 2019

Virgin microplastics are not causing imminent harm to fish after dietary exposure.

Mar Pollut Bull 2018 May 20;130:123-131. Epub 2018 Mar 20.

Institute of Marine Sciences, Middle East Technical University, Erdemli, Mersin, Turkey.

Among aquatic organisms, fish are particularly susceptible to ingesting microplastic particles due to their attractive coloration, buoyancy, and resemblance to food. However, in previous experimental setups, fish were usually exposed to unrealistically high concentrations of microplastics, or the microplastics were deliberately contaminated with persistent organic chemicals; also, in many experiments, the fish were exposed only during the larval stages. The present study investigated the effects of virgin microplastics in gilt-head seabream (Sparus aurata) after 45 days' exposure at 0.1 g kg bodyweight day to 6 common types of microplastics. The overall growth, biochemical analyses of the blood, histopathology, and the potential of the microplastics to accumulate in gastrointestinal organs or translocate to the liver and muscles were monitored and recorded. The results revealed that ingestion of virgin microplastics does not cause imminent harm to the adult gilt-head seabream during 45 days of exposure and an additional 30 days of depuration. The retention of virgin microplastics in the gastrointestinal tract was fairly low, indicating effective elimination of microplastics from the body of the fish and no significant accumulation after successive meals. Therefore, both the short- and the long-term retention potential of microplastics in the gastrointestinal tract of fish is close to zero. However, some large particles remained trapped in the liver, and 5.3% of all the livers analyzed contained at least one microplastic particle. In conclusion, the dietary exposure of S. aurata to 6 common types of virgin microplastics did not induce stress, alter the growth rate, cause pathology, or cause the microplastics to accumulate in the gastrointestinal tract of the fish.
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http://dx.doi.org/10.1016/j.marpolbul.2018.03.016DOI Listing
May 2018

Microplastic does not magnify the acute effect of PAH pyrene on predatory performance of a tropical fish (Lates calcarifer).

Aquat Toxicol 2018 May 12;198:287-293. Epub 2018 Mar 12.

Section for Oceans and Arctic, National Institute of Aquatic Resources, Technical University of Denmark, Denmark. Electronic address:

Microplastic (MP) leads to widespread pollution in the marine ecosystem. In addition to the physical hazard posed by ingestion of microplastic particles, concern is also on their potential as vector for transport of hydrophobic contaminants. We experimentally studied the single and interactive effects of microplastic and pyrene, a polycyclic aromatic hydrocarbon, on the swimming behaviour and predatory performance of juvenile barramundi (Lates calcarifer). Juveniles (18+ days post hatch) were exposed to MPs, or pyrene (100 nM), or combination of both, and feeding rate and foraging activity (swimming) were analysed. Exposure to MPs alone did not significantly influence feeding performance of the juveniles, while a dose-effect series of pyrene showed strong effect on fish behaviour when concentrations were above 100 nM. In the test of combined MP and pyrene exposure, we observed no effect on feeding while swimming speed decreased significantly. Thus, our results confirm that short-time exposure to pyrene impacts the performance of fish juveniles, while additional exposure to microplastic at the given conditions influenced their activity only and not their feeding rate. Further studies of the combined effects of microplastics and pollutants on tropical fish behaviour are encouraged.
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http://dx.doi.org/10.1016/j.aquatox.2018.03.011DOI Listing
May 2018

Microplastic litter composition of the Turkish territorial waters of the Mediterranean Sea, and its occurrence in the gastrointestinal tract of fish.

Environ Pollut 2017 Apr 20;223:286-294. Epub 2017 Jan 20.

Institute of Marine Sciences, Middle East Technical University, Erdemli, Mersin, Turkey.

Microplastic pollution of marine environment is receiving increased publicity over the last few years. The present survey is, according to our knowledge, the survey with the largest sample size analyzed, to date. In total, 1337 specimens of fish were examined for the presence of plastic microlitter representing 28 species and 14 families. In addition, samples of seawater and sediment were also analyzed for the quantification of microplastic in the same region. Samples of water/sediment were collected from 18 locations along the Mediterranean coast of Turkey. 94% of all collected plastic microlitter from the sea was in the size range between 0.1 and 2.5 mm, while the occurrence of other sizes was rare. The quantity of microplastic particles in surface water samples ranged from 16 339 to 520 213 per km. Fish were collected from 10 locations from which 8 were either shared with or situated in the proximity of water/sediment sampling locations. A total of 1822 microplastic particles were extracted from stomach and intestines of fish. Majority of ingested particles were represented by fibers (70%) and hard plastic (20.8%), while the share of other groups: nylon (2.7%), rubber (0.8%) and miscellaneous plastic (5.5%) were low. The blue color of plastic was the most dominant color. 34% of all examined fish had microplastic in the stomach. On average, fish which had microplastic contained 1.80 particles per stomach. 41% of all fish had microplastic in the intestines with an average of 1.81 particles per fish. 771 specimens contained microplastic in either stomach and/or intestines representing 58% of the total sample with an average of 2.36 particles per fish. Microplastic was found in all species/families that had sample size of at least 2 individuals. The number of particles present in either stomach or intestines ranged between 1 and 35. Ingested microplastic had an average diameter ±SD of 656 ± 803 μm, however particles as small as 9 μm were detected. The trophic level of fish species had no influence whatsoever on the amount of ingested microplastic. Pelagic fish ingested more microplastic than demersal species. In general, fish that ingested higher number of microplastic particles originated from the sites that also had a higher particle count in the seawater and sediment.
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http://dx.doi.org/10.1016/j.envpol.2017.01.025DOI Listing
April 2017

Low protein content of drainage fluid is a good predictor for earlier chest tube removal after lobectomy.

Interact Cardiovasc Thorac Surg 2014 Oct 3;19(4):650-5. Epub 2014 Jul 3.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

Objectives: Owing to the great absorption capability of the pleura for transudates, the protein content of draining pleural fluid may be considered as a more adequate determinant than its daily draining amount in the decision-making for earlier chest tube removal. In an a priori pilot study, we observed that the initially draining protein-rich exudate converts to a transudate quickly in most patients after lobectomies. Thus, chest tubes draining high-volume but low-protein fluids can safely be removed earlier in the absence of an air leak. This randomized study aims to investigate the validity and clinical applicability of this hypothesis as well as its influence on the timing for chest tube removal and earlier discharge after lobectomy.

Methods: Seventy-two consecutive patients undergoing straightforward lobectomy were randomized into two groups. Patients with conditions affecting postoperative drainage and with persisting air leaks beyond the third postoperative day were excluded. Drains were removed if the pleural fluid to blood protein ratio (PrRPl/B) was ≤0.5, regardless of its daily draining amount in the study arm (Group S; n = 38), and patients in the control arm (Group C; n = 34) had their tubes removed if daily drainage was ≤250 ml regardless of its protein content. Patients were discharged home immediately or the following morning after removal of the last drain. All cases were followed up regarding the development of symptomatic pleural effusions and hospital readmissions for a redrainage procedure.

Results: Demographic and clinical characteristics as well as the pattern of decrease in PrRPl/B were the same between groups. The mean PrRPl/B was 0.65 and 0.67 (95% CI = 0.60-0.69 and 0.62-0.72) on the first postoperative day, and it remarkably dropped down to 0.39 and 0.33 (95% CI = 0.33-0.45 and 0.27-0.39) on the second day in Groups S and C, respectively, and remained below 0.5 on the third day (repeated-measures of ANOVA design, post hoc 'within-group' comparison of the first postoperative day versus second and third days; P < 0.002). Eleven of 38 (29%) and 16 of 27 (59%) patients' chest tubes were, respectively, removed on the first and second postoperative days in Group S, but only two of 34 (6%) and ten of 32 (31%) patients, respectively, had their chest tubes removed in Group C (two-tailed Fisher's exact test, P = 0.02 and 0.005 for the first and the second postoperative days, respectively). On the third postoperative day, daily drainage remained ≥250 ml in 22 (65%) patients, among whom, 17 (77%) would have their chest tubes removed on the PrRPl/B value in Group C. However, drains could not be removed due to the high protein content of draining fluid despite the acceptable volume of daily drainage in only three (27%) of 11 cases in Group S (McNemar's paired proportions test, P = 0.009). The mean chest tube removal time (2.1 ± 0.9 vs 2.9 ± 1.0 days; P < 0.001) and the median hospital stay [3 days (IQR: 1-3) vs 4 days (IQR: 2-4), P < 0.003] were significantly shorter in Group S. None of the patients required a redrainage procedure due to a persistent and symptomatic pleural effusion.

Conclusions: Regardless of the daily drainage, chest tubes can safely be removed earlier than anticipated in most patients after lobectomy if the protein content of the draining fluid is low.
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http://dx.doi.org/10.1093/icvts/ivu207DOI Listing
October 2014

Management of bilateral pneumothoraces after talc pleurodesis and unilateral lung volume reduction surgery.

Interact Cardiovasc Thorac Surg 2010 May 1;10(5):830-2. Epub 2010 Feb 1.

Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

Lung volume reduction surgery (LVRS) is one of the surgical options in the treatment of advanced emphysema and may also be considered as a 'bridge' operation to lung transplantation in selected patients. Although its long-term effects are still debatable, some patients significantly benefit from this operation. Secondary spontaneous pneumothorax is one of the commonest complications of severe emphysema that necessitates an emergency drainage procedure. However, there is no satisfactory information regarding the management of this complication occurring after LVRS in the literature. This paper reports a case of bilateral pneumothorax three months after a unilateral LVRS that was performed following a contra-lateral talc pleurodesis for recurrent pneumothorax.
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http://dx.doi.org/10.1510/icvts.2009.224931DOI Listing
May 2010

Management of acquired bronchobiliary fistula: 3 case reports and a literature review.

J Cardiothorac Surg 2007 Dec 3;2:52. Epub 2007 Dec 3.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, Istanbul, Turkey.

Bronchobiliary fistula (BBF), which often presents with bilioptysis, is an abnormal communication between the bronchial system and biliary tree. It is a complication associated with a high mortality rate and requires a well-planned management strategy. Although hydatid disease is still the leading cause, extensive surgical interventions and invasive procedures of the liver have altered the profile of patients in recent decades. This paper presents 3 cases of BBF and reviews the literature regarding the treatment options generally mandated by clinical presentation and the underlying disease.
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http://dx.doi.org/10.1186/1749-8090-2-52DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2217537PMC
December 2007

Giant carcinoid tumor mimicking pulmonary sequestration.

Ann Thorac Surg 2007 Oct;84(4):1375-6

Department of Thoracic Surgery, Sureyyapasa Chest Diseases, Chest Surgery Training and Research Hospital, Istanbul, Turkey.

A 42-year-old woman who previously underwent two consecutive thoracotomies for a lower lobe mass in her right lung was referred to our clinic for further management. Both procedures were abandoned due to excessive bleeding. Computed tomographic angiography demonstrated an infra-diaphragmatic systemic arterial supply of the mass similar to pulmonary sequestration. However the lobe had a normal venous drainage to the left atrium. Then a right lower lobectomy was undertaken through a hemi-clamshell incision, and histopathology revealed an atypical carcinoid tumor. The patient was discharged home after a satisfactory postoperative period. She still remains disease free at 14 months follow-up.
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http://dx.doi.org/10.1016/j.athoracsur.2007.05.041DOI Listing
October 2007

How does definition of 'complete resection' conduct surgical management of non-small cell lung cancer?

Interact Cardiovasc Thorac Surg 2006 Oct 1;5(5):643-5. Epub 2006 Jun 1.

Department of Thoracic Surgery, Sureyyapasa Chest Diseases, Thoracic and Cardiovascular Surgery Teaching and Research Hospital, Istanbul, Turkey.

The term 'complete resection' is traditionally defined as a desired surgical procedure if a considerable survival benefit is anticipated in patients with NSCLC. From a surgeon's viewpoint, it is therefore of great importance in patient selection for thoracotomy. In this setting, one might assume that well-known definitions of Naruke and Mountain with different meanings would subsequently result in a number of conflicting influences. As a result, patient selection criteria for surgery, the role and reliability of invasive staging procedures and futile thoracotomy rates are unavoidably conducted by the definition preferred. Interpretation of the outcomes from the series with different attitudes may also be misleading. Thus, outset of the surgical management of NSCLC should be based on the definition and preferences associated with complete resection. To conclude, if we could depict a universally accepted definition of complete resection which could also easily be attributable to the existing guidelines; contribution of surgery would have been more clearly outlined among other treatment modalities. This will in turn, not only eliminate most of the confusion that a surgeon might have in his/her mind regarding the matter, but might also provide a more stronger evidence for the role of surgery in the long term.
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http://dx.doi.org/10.1510/icvts.2006.130690DOI Listing
October 2006

Antibiotics are not needed during tube thoracostomy for spontaneous pneumothorax: an observational case study.

J Cardiothorac Surg 2006 Nov 13;1:43. Epub 2006 Nov 13.

Department of Thoracic Surgery, Sureyyapasa Chest and Cardiovascular Diseases Teaching and Research Hospital, Istanbul, Turkey.

Background: Usefulness of prophylactic antibiotics following tube thoracostomy remains controversial in the literature. In this study, we aimed to investigate the consequences of closed tube thoracostomy for primary spontaneous pneumothorax without the use of antibiotics.

Methods: One-hundred and nineteen patients underwent tube thoracostomy for primary spontaneous pneumothorax. None of them received prophylactic antibiotic treatment. Eight patients with prolonged air leak undergoing either video assisted thoracoscopic surgery or thoracotomy were excluded.

Results: Of the remaining 111 (104 male and 7 female), 28 (25%) patients developed some induration around the entry site of chest tube that settled without further treatment. White blood cell count was high without any other evidence of infection in 12 (11%) patients and returned to its normal levels before discharge home in all. There was also some degree of fever not lasting for more than 48 hours in 8 (7%) patients. Bacterial cultures from suspected sites did not reveal any significant growth in these patients.

Conclusion: Prophylactic antibiotic treatment seems avoidable during closed tube thoracostomy for primary spontaneous pneumothorax. This policy was not only cost-effective but also prevented our patients from detrimental properties of unnecessary antibiotic use, such as development of drug resistance and undesirable side effects.
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http://dx.doi.org/10.1186/1749-8090-1-43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1647271PMC
November 2006

Pleural flap to prevent lobar torsion: A novel technique.

Eur J Cardiothorac Surg 2006 Dec 18;30(6):943-4. Epub 2006 Oct 18.

Department of Thoracic Surgery, Sureyyapasa Chest and Cardiovascular Diseases Teaching and Research Hospital, Istanbul, Turkey.

Lobar torsion is reported as very rare but sometimes catastrophic complication if overlooked during the early postoperative period following a lobectomy, though it is totally preventable. In this novel technique, a piece of parietal pleural flap is harvested from the posterior wall of the chest using a hook diathermy while keeping its upper border as close to the apex as possible. Finally, distal end of the flap is secured to the upper edge of the lobe using a fine monofilament absorbable suture. This procedure not only protects the lobe from rotation but also maintains continuous expansion of the lung in the early postoperative period and may, therefore, be a good option to prevent such a serious complication in selected patients following a lobectomy.
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http://dx.doi.org/10.1016/j.ejcts.2006.09.015DOI Listing
December 2006

Decision-making for lung resection in patients with empyema and collapsed lung due to tuberculosis.

J Thorac Cardiovasc Surg 2005 Jul;130(1):131-5

Department of Thoracic Surgery, Yedikule Hospital for Chest Diseases and Chest Surgery, Jakki Yelen Cad. 17/12, Sişli 80200, Istanbul, Turkey.

Objective: Collapsed lung with associated empyema is a different clinical entity from destroyed lung . A low perfusion rate of the diseased lung is usually considered an indication for pneumonectomy in patients undergoing thoracotomy for tuberculosis. Such a criterion may not adequately reflect the functional capacity of the underlying parenchyma when the lung is collapsed.

Methods: One hundred twenty-seven patients underwent thoracotomy for tuberculosis at our hospital between 1998 and 2003. Among these, 5 (4%) patients who had a collapsed lung for more than 3 months and pleural infection were the subjects of this study. Surgery was considered after at least a 3-month course of regular antituberculous treatment. Despite no perfusions in 2 patients and 8%, 10%, and 15% perfusion rates for the remaining 3 patients, decortication alone was intentionally performed, and any kind of resectional operation was avoided.

Results: The lung gradually filled the hemithorax between 5 and 12 days after surgery in 4 patients. The remaining patient required a thoracomyoplasty 8 weeks after the initial operation. Repeated perfusion scans 1 and 2 years after decortication continued to show no perfusion in patients who had had no preoperative perfusion. All patients were symptom free on regular follow-up between 10 months and 4.5 years.

Conclusions: It seems that the outcome is unpredictable in terms of lung expansion after decortication, which is a relatively simple procedure compared with other surgical options. We think that the risk of rethoracotomy is acceptable, considering the devastating complications and high mortality rates of resectional surgery in the treatment of such patients.
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http://dx.doi.org/10.1016/j.jtcvs.2004.08.040DOI Listing
July 2005

Carcinoma in situ from the view of complete resection.

Lung Cancer 2004 Dec;46(3):383-5

World Health Organisation (WHO) defined three types of preinvasive epithelial lesions, one of which is preinvasive bronchial squamous lesions consisting of dysplasia and carcinoma in situ (CIS). It is not clear whether or not CIS at the bronchial resection margin is to be considered as incomplete resection in the literature. Follow-up data of such patients using autofluorescence bronchoscopy proved that CIS regresses without further treatment in significant number of patients. It is therefore reasonable to accept any reported CIS lesion on frozen-section examination as complete clearance of the tumor and thus further resection may not be warranted.
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http://dx.doi.org/10.1016/j.lungcan.2004.05.008DOI Listing
December 2004