Publications by authors named "Mertol Gokce"

11 Publications

  • Page 1 of 1

The Histopathological Effects of Reabsorbable Polyethylene Glycol Hydrogel (Coseal®) on Epidural Fibrosis in an Experimental Post-Laminectomy Model in Rats.

Turk J Med Sci 2021 Jan 17. Epub 2021 Jan 17.

Background: To investigate the histopathological effects of reabsorbable polyethylene glycol hydrogel (RPGH, Coseal®) on epidural fibrosis (EF) following laminectomy in rats.

Methods: A total of 24 rats were equally divided into three groups. In the first group, no treatment was applied after laminectomy (control group, Group 1). In the second group, hemostasis was achieved after laminectomy, and 2 mm absorbable gelatin sponge soaked in saline was placed over the epidural space and the wound was closed (Group 2). In the third group, hemostasis was achieved following laminectomy, and 0.5 mL RPGH (Coseal®, Group 3) was squeezed over the dura mater, and the wound was closed. A histopathological examination was undertaken to evaluate arachnoidal invasion and EF.

Results: The results of EF in the Group 2 and Group 3 were significantly lower compared to the Group 1 (p = 0.023 and p = 0.002, respectively). No statistically significant difference was found between the Group 2 and Group 3 in terms of EF (p = 0.957). There was also no statistically significant difference between the mean arachnoidal invasion of the three groups (p > 0.171). However, the rate of arachnoidal invasion was the lowest in the Group 3.

Conclusions: Intraoperative Coseal®, a polyethylene glycol polymer, tends to reduce the risk of epidural fibrosis, although this is not statistically significant.
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http://dx.doi.org/10.3906/sag-2009-241DOI Listing
January 2021

Efficacy of uniportal video-assisted thoracoscopic pericardial window creation using two lung ventilation in chronic large pericardial effusions.

J Pak Med Assoc 2020 Oct;70(10):1742-11747

Department of Pathology, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.

Objective: To demonstrate that two lung ventilation under general anaesthesia may also be safely performed to create pericardial window with uniportal video-assisted thoracoscopic surgery.

Method: The single-centre, retrospective, comparative study was conducted at Bulent Ecevit University, Zonguldak, Turkey, comprised data from March 2011 to March 2018 of patients with recurrent and/or with chronic large pericardial effusions unresponsive to medical therapy and/or to pericardiocentesis and who underwent pericardial window creation with uniportal video-assisted thoracoscopic surgery. Group 1 had data of patients in whom pericardial windows were created under general anaesthesia, while group 2 had patients with two lung ventilation. Parameters compared between the groups were gender, age, operation side, operation time amount of drainage, complication, recurrences and survival. Data was analysed using SPSS 19.

Results: Of the 20 patients, 9(45%) were males and 11(55%) were females. Group 1 had 14(70%) patients, while group 2 had 6(30%). The age of patients in group 2 was significantly higher than those in group 1 (p=0.041). There was no significant difference between the groups with respect to gender, amount of drainage, operation time and post-operative complications (p>0.05). There was no recurrence or mortality in either of the two groups.

Conclusions: Pericardial window could be created safely with video-assisted thoracoscopic surgery under two lung ventilation for patients carrying high risk for one lung ventilation.
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http://dx.doi.org/10.5455/JPMA.28968DOI Listing
October 2020

Chylothorax due to leukemic infiltration in a patient with chronic lymphocytic leukemia.

Respir Med Case Rep 2015 25;16:131-3. Epub 2015 Sep 25.

Bülent Ecevit University, Faculty of Medicine, Department of Pulmonary Medicine, Zonguldak, Turkey.

Chylothorax is characterized by accumalation of milky fluid called chyle into the plural space. Most common causes of cyhlothorax are trauma or surgery of thoracic duct and malignancies. Among the malignancies lymphoma is responsible approximately 70% of cyhlothorax but other lymphocytic tumors including chronic lymphocytic leukemia (CLL) is rarely reported. A 71 years old man with known CLL, presented with dispnea and pleural effusion and diagnosed cyhlothorax due to leukemic infiltration that confirmed by immuno flow cytometric analyse.
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http://dx.doi.org/10.1016/j.rmcr.2015.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4681962PMC
January 2016

The palliative treatment with intrapleural streptokinase in patients with multiloculated malignant pleural effusion: a double-blind, placebo-controlled, randomized study.

Med Oncol 2015 Jun 10;32(6):612. Epub 2015 May 10.

Thoracic Surgery Department, Yedikule Teaching Hospital for Chest Diseases and Thoracic Surgery, Istanbul, Turkey.

Expansion of the lung is necessary for successful pleurodesis therapy in patients with malignant pleural effusion (MPE). However, this is often impossible in multiloculated MPEs. The aim of this study was to investigate the effect of the fibrinolytic agent, streptokinase, on pleurodesis therapy used in the management of multiloculated MPE. Forty patients with multiloculated MPEs were randomly assigned to two groups: fibrinolytic and control. In the fibrinolytic group, 250,000 IU of streptokinase in 50 ml saline was applied into the pleural space at 24-36-48-60 h after opening a tube thoracostomy. In the control group, the same procedure was carried out using only 50 ml saline solution. Both groups were compared based on the following: (1) volume of pleural drainage at 24-48, 48-72, and 24-72 h, (2) chest computer tomography images before and after therapy, (3) dyspnea symptoms after therapy, and (4) recurrence rate. The mean drainage volumes for the fibrinolytic and control groups were 493 and 248 cc at 24-48 h, 446 and 198 cc at 48-72 h, and 939 and 446 cc at 24-72 h (P < 0.001). Comparison of the two groups by computer tomography revealed that 17 patients (85 %) in the fibrinolytic group had greater than 40 % improvement, whereas only 7 patients (35 %) in the control group had the same degree of improvement (P = 0.001). The dyspnea symptoms disappeared in 90 % of the patients in the fibrinolytic group and in 55 % of the patients in the control group (P = 0.03). Recurrence rate was 11 % in fibrinolytic group and 45 % in control group (P = 0.07). Streptokinase is a reliable treatment option in obtaining effective pleural drainage and increasing lung expansion in patients with multiloculated MPE.
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http://dx.doi.org/10.1007/s12032-015-0612-0DOI Listing
June 2015

Effect of ghrelin on inflammatory response in lung contusion.

Kaohsiung J Med Sci 2013 Feb 18;29(2):69-74. Epub 2012 Oct 18.

Department of Biochemistry, Faculty of Medicine, Bulent Ecevit University (Formerly Karaelmas University), Zonguldak, Turkey.

The purpose of this study was to investigate the effects of ghrelin on inflammatory response and tissue damage following trauma-induced acute lung injury. Thirty male wistar albino rats (300-400 g) were randomly assigned into three groups: control group (n = 6), lung contusion plus saline (saline-treated, n = 12), and lung contusion plus ghrelin (ghrelin-treated, n = 12). Saline- or ghrelin-treated traumatic rats were sacrificed at two time points (24 and 72 hours) after lung contusion. Blood was collected for the analysis of serum adenosine deaminase (ADA). Tissue transforming growth factor-beta 1 (TGF-β1) and matrix metalloproteinase-2 (MMP-2) levels were measured by enzyme-linked immunosorbent assay and histopathological examination was performed on the lung tissue samples. Our results indicated that ghrelin significantly reduced morphologic damages. Serum ADA activities were significantly decreased after lung contusion and this decline started early with ghrelin treatment. TGF-β1 and MMP-2 levels in lung tissue were elevated at 72 hours after lung contusion and treatment with ghrelin significantly increased TGF-β1 level and reduced MMP-2 level. In conclusion, our study demonstrates that acute lung injury initiated proinflammatory responses and ghrelin administration showed an anti-inflammatory effect in lung contusion.
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http://dx.doi.org/10.1016/j.kjms.2012.08.011DOI Listing
February 2013

Antioxidant vitamins C, E and coenzyme Q10 vs dexamethasone: comparisons of their effects in pulmonary contusion model.

J Cardiothorac Surg 2012 Sep 26;7:92. Epub 2012 Sep 26.

Department of Thoracic Surgery, Karaelmas University Medical Faculty, Zonguldak, Turkey.

Background: The goal of our study is to evaluate the effects of antioxidant vitamins (vitamin C and E), Coenzyme Q10 (CoQ10) and dexamethasone (Dxm) in experimental rat models with pulmonary contusion (PC).

Methods: Rats were randomly divided into six groups. Except for the control, all subgroups had a moderate pulmonary contusion. Animals in the group I and group II received intraperitoneal saline, group III received 10mg.kg-1 CoQ10 group IV received 100mg.kg-1 vitamin C, group V received 150 mg.kg-1 vitamin E, and group VI received 10mg.kg-1 Dxm. Blood gas analysis, serum nitric oxide (NO) and malondialdehyde (MDA) levels as well as superoxide dismutase (SOD) activity assays, bronchoalveolar lavage (BAL) fluid and histopathological examination were performed.

Results: Administration of CoQ10 resulted in a significant increase in PaO2 values compared with the group I (p = 0.004). Levels of plasma MDA in group II were significantly higher than those in the group I (p = 0.01). Early administration of vitamin C, CoQ10, and Dxm significantly decreased the levels of MDA (p = 0.01). Lung contusion due to blunt trauma significantly decreased SOD activities in rat lung tissue compared with group I (p = 0.01). SOD levels were significantly elevated in animals treated with CoQ10, Vitamin E, or Dxm compared with group II (p = 0.01).

Conclusions: In our study, CoQ10, vitamin C, vitamin E and Dxm had a protective effect on the biochemical and histopathological outcome of PC after experimental blunt thorax trauma.
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http://dx.doi.org/10.1186/1749-8090-7-92DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487991PMC
September 2012

Accuracy of positron emission tomography in mediastinal node assessment in coal workers with lung cancer.

Med Oncol 2012 Jun 6;29(2):589-94. Epub 2011 Mar 6.

Department of Thoracic Surgery, Karaelmas University Faculty of Medicine, Zonguldak, Turkey.

The purpose of this study was to explore the accuracy of (18)F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) in the assessment of mediastinal lymph node in coal workers who had non-small cell lung cancer. We retrospectively reviewed 42 retired coal workers who had lung cancer without distant metastasis, between May 2007 and May 2010. Regarding the mediastinal lymph nodes, when the standard uptake value was greater than 2.5, it was considered "malignancy positive." After histological examination of the mediastinal lymph nodes, anthracotic and metastatic ones were detected. The results of PET/CT were analyzed to determine its accuracy. Of these 42 patients, PET/CT detected 47 positive mediastinal lymph nodes in 24 patients with a mean SUV maximum of 6.2 (2.6-13.8). One hundred and thirty-one mediastinal lymph node foci were dissected. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FDG-PET/CT in detecting nodal metastases were 84% (16/19), 65% (15/23), 66% (16/24), 83% (15/18), and 74% (31/42) on a per-patient basis, respectively. Mediastinal node staging with FDG-PET/CT in coal workers is insufficient due to the high false-positive rates due to the presence of pneumoconiosis. In these patients, an invasive technique such as mediastinoscopy seems mandatory for confirmation of ipsilateral or contralateral mediastinal lymph node metastasis.
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http://dx.doi.org/10.1007/s12032-011-9879-yDOI Listing
June 2012

Giant bulla mimicking tension pneumothorax.

Tuberk Toraks 2009 ;57(4):435-8

Department of Chest Surgery, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, Turkey.

In the chest X-ray, we observe tension pneumothorax (TPX) as wide radiolucent view in a hemithorax and pushing the mediastinal structures contralateral. Giant bulla may mimic TPX with wide radiolucent view and mediastinal shift. The present report includes giant pulmonary bulla in 35-year-old woman. The giant bulla was diagnosed as a TPX in emergency, and chest tube was performed. The differentiation between TPX and a giant bulla may be very difficult. The therapies of these two similar entities are completely different. So that, we must be careful about anamnesis, physical examination and radiology for true diagnosis.
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March 2010

CT-guided transthoracic fine needle aspiration of pulmonary lesions: accuracy and complications in 134 cases.

Tuberk Toraks 2009 ;57(2):177-85

Clinic of Chest Diseases, Sureyyapaşa Chest Diseases and Chest Surgery Training and Research Hospital, Istanbul, Turkey.

The aim of this study was to perform a prospective evaluation of the effectiveness of computed tomography (CT)-guided transthoracic fine needle aspiration (TFNA) in the diagnosis of pulmonary lesions and to determine the complication rate of this procedure. A prospective review was conducted of 134 patients who underwent CT-guided TFNA at our center between December 2003 and August 2005. All fine needle aspirations were performed with a 22-gauge single-pass Chiba needle under CT guidance. The biopsies were performed by one pulmonologist. Two hundred twenty two (91%) malignant lesions and 12 (9%) benign lesions were reviewed in the present study. An accurate diagnosis was made in 107 (88%) of the 122 malignant lung lesions and a specific diagnosis was obtained in 42% of the benign lesions. The sensitivity of TFNAs for the detection of malignancy was 83%, and the overall accuracy of TFNA for diagnosing malignancy was 84%. Pneumothorax occurred in 22 of the 134 patients (16%). Pneumothorax was more frequently observed in centrally located lesions (p= 0.001). Our results suggest that CT-guided TFNA has a high diagnostic accuracy and an acceptable rate of complications. Moreover, we suggest that the most important factor increasing the risk of pneumothorax is an increase in the depth of aerated lung traversed for sampling.
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January 2010

Lung decortication for chronic empyaema: effects on pulmonary function and thoracic asymmetry in the late period.

Eur J Cardiothorac Surg 2009 Oct 16;36(4):754-8. Epub 2009 Jun 16.

Sureyyapasa Chest Diseases and Thoracic Surgery Teaching Hospital, Maltepe 34758, Istanbul, Turkey.

Objective: Chronic empyaema deteriorates lung function and causes thoracic asymmetry due to intercostal narrowing in the diseased hemithorax. This study aims to investigate the rates of improvement in the pulmonary function tests (PFTs) and the thoracic deformity in late postoperative period of lung decortication, performed for chronic empyaema.

Methods: A total of 50 patients who underwent standard open decortication for empyaema were included. The PFTs and computed tomographic (CT) scans of the chest were analysed in all patients after 6-58 months postoperatively. The measurements of antero-posterior and transverse diameters of both hemithoraxes were performed on both preoperative and postoperative chest CTs. The thoracic asymmetry was calculated as the ratio of the measurements of the diseased side to the normal side. The pre- and postoperative parameters were compared statistically.

Results: The mean preoperative forced expiratory volume in first second (FEV(1)) and forced vital capacity (FVC) increased from 61.40% and 60.89% to 78.92% and 77.48%, respectively, in the late postoperative period (p<0.001). The mean preoperative transverse diameter of affected hemithorax increased from 11.22 cm to 11.98 cm (p<0.001) and, the transverse asymmetry improved from 11.52% to 5.94%, postoperatively (p<0.001). The mean preoperative antero-posterior chest diameter improved from 15.58 cm to 16.67 cm (p<0.001), and the antero-posterior asymmetry improved from 11.42% to 5.42% (p<0.001) in the late postoperative period.

Conclusions: The open decortication for chronic pleural empyaema significantly increases FEV(1) and FVC. Due to the re-expansion of the lung and enlargement of the intercostal spaces, the chest wall deformity also improves considerably after the operation.
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http://dx.doi.org/10.1016/j.ejcts.2009.04.043DOI Listing
October 2009

Comparison of the single or double chest tube applications after pulmonary lobectomies.

Eur J Cardiothorac Surg 2009 Jan 16;35(1):32-5; discussion 35-6. Epub 2008 Oct 16.

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

Objective: Draining of the chest cavity with two chest tubes after pulmonary lobectomy is a common practice. This study aimed to investigate whether using two tubes after a pulmonary lobectomy is more effective than using a single tube.

Method: This prospective randomised study included 100 consecutive patients who underwent lobectomy or bilobectomy for any pathological condition between May 2006 and November 2007. In the 50 patients in the 'single-tube group', only one 32F chest tube was inserted, and in the 50 patients in the 'double-tube group', two 32F chest tubes were inserted. Pre-, intra- and postoperative variables in both the groups were compared.

Results: The pre- and intraoperative characteristics of the patients were similar in both groups. The mean amount of drainage from chest tubes was 600+/-43.2cc in the single-tube group and 896+/-56.2cc in the double-tube group (p<0.001). The mean values of postoperative pain assessed on the visual analogue scale (VAS) in the early (second day) period were 4.28+/-0.21 in the single-tube group and 5.10+/-0.23 in the double-tube group (p=0.014). The VAS scores in the late (second week) period were 1.48+/-0.13 in the single-tube group and 2.00+/-0.17 in the double-tube group (p=0.01). All other related parameters were similar in both groups.

Conclusions: Insertion of two chest tubes is not more effective than the insertion of a single chest tube after pulmonary lobectomy. Moreover, using a single tube is in fact more effective than using two tubes in that it causes less postoperative pain and less pleural fluid loss.
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http://dx.doi.org/10.1016/j.ejcts.2008.09.009DOI Listing
January 2009