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    A case of spontaneous pneumomediastinum with unknown etiology
    (Derman Medical Publ, 2019) Alar, Timucin; Bayram, Ahmet Sami; Gedik, Ismail Ertugrul
    First described by Hamman in 1939, spontaneous pneumomediastinum (SPM) is a disease with the collection of air in the mediastinum without any underlying cause. It is usually seen in young males and its incidence is reported between 1/15000-1/25000 in different case series. We would like to present the case of a 16-year-old male patient who admitted to our hospital with the complaints of pleuritic chest pain and tenderness in the neck and was diagnosed as spontaneous pneumomediastinum. Patient spontaneously recovered without the need of an invasive procedure.
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    Clinical Picture, Radiological Findings, and Physical Examination in Tracheobronchial Foreign Body Aspiration: Which One is More Important?
    (Aves, 2013) Gedik, Ismail Ertugrul; Alar, Timucin; Omur, Dilek; Akdur, Okhan
    Tracheobronchial foreign body aspiration is more frequent in children between 6 months-3 years of age, whereas it is seen less often in adults. The diagnosis of TBFB aspiration can be delayed in the adult population due to the lack of clinical suspicion. A case of a 56-year-old male patient admitted to the emergency department with a history of aspiration of a piece of carrot 4 hours previously, a cough and stridorous breathing is presented. His physical examination revealed reduced respiratory sounds in the lower zone of the left lung. There was no radiological clue of a tracheobronchial foreign body. Thus, we performed rigid bronchoscopy and found that the left lower lobe basal segment bronchus was almost totally obstructed by a foreign body (carrot) of 1.5x1 cm, which was removed. This was based on the clinical suspicion derived from the history and the physical examination alone. We emphasise that history and physical examination are more important in the diagnosis of organic or non-opaque tracheobronchial foreign body aspiration.
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    Cutaneous Metastasis of Large Cell Lung Cancer: A Case Report
    (Derman Medical Publ, 2016) Gedik, Ismail Ertugrul; Alar, Timucin; Muratli, Ash
    Lung cancer has the highest incidence among all cancer types in the world. Skin is an uncommon organ that lung cancers metastasize and the incidence of cutaneous metastasis has been reported between 1-12%. In this report, we would like to present the case of a 67 year old male patient who admitted to our hospital with the complaint of multiple swollen masses on the different parts of his skin and has a homogenous mass with the width of 3 cm on chest x ray. The nodule at the intersection of the right 6th intercostal space and the mid-axillary line and with the dimensions of 1.5x1 cm was excised under local anesthesia and the specimen was sent to the pathology laboratory for histopathological examination. The diagnosis of large cell neuroendocrine carcinoma was made histopathologically. The patient was diagnosed as the distant metastasis of the large cell lung cancer, considered inoperable and referred to oncology clinics.
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    Is it safe to work in a fast-food kitchen? a case of recurrent spontaneous pneumothorax with cholesterol granuloma
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2015) Alar, Timucin; Muratli, Asli; Uludağ, Ahmet; Gedik, Ismail Ertugrul
    Cholesterol granulomas are defined as cystic lesions containing cholesterol crystals surrounded by foreign body giant cells, fibrous tissue reaction and chronic inflammation. A 31-year-old male patient presented at the thoracic surgery outpatient clinic with a left apical recurrent pneumothorax. Bullectomy with multiple wedge resections was performed through a mini-thoracotomy. Histopathological examination of the resection material showed emphysematous lung and bullae + cholesterol granuloma. The patient had been working in a fast-food kitchen and at the french fries section, in particular, for nearly the past four years and had been exposed through inhalation to exogenous oil and oil products derived from vaporized vegetable and animal oil. We believe that staff working at a fast food kitchen and at the french fries section, in particular, should work using protective measures such as a mask and good ventilation.
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    Löfgren's syndrome: An acute variant of sarcoidosis diagnosed by mediastinoscopy
    (College of Physicians and Surgeons Pakistan, 2015) Alar, Timuçin; Gunes, Fahri; Muratli, Asli; Gedik, Ismail Ertugrul; Tekeli, Zeliha; Ukinc, Kubilay
    Löfgren's syndrome is an acute clinical form of sarcoidosis that is first described by Sven Löfgren as bilateral hilar lymphadenopathy together with Erythema Nodosum (EN) and accompanying arthritis/arthralgia. This syndrome has some differences in terms of treatment, prognosis and recurrence compared to sarcoidosis. In this report, we describe a 70 years old lady who admitted with multiple erythematous lesions and arthralgia of both lower extremities and she was diagnosed as Löfgren's syndrome via mediastinoscopy.
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    Lofgren's Syndrome: An Acute Variant of Sarcoidosis Diagnosed by Mediastinoscopy
    (Coll Physicians & Surgeons Pakistan, 2015) Alar, Timucin; Gunes, Fahri; MuratlE, Asli; Gedik, Ismail Ertugrul; Tekeli, Zeliha; Ukinc, Kubilay
    Lofgren's syndrome is an acute clinical form of sarcoidosis that is first described by Sven Lofgren as bilateral hilar lymphadenopathy together with Erythema Nodosum (EN) and accompanying arthritis/arthralgia. This syndrome has some differences in terms of treatment, prognosis and recurrence compared to sarcoidosis. In this report, we describe a 70 years old lady who admitted with multiple erythematous lesions and arthralgia of both lower extremities and she was diagnosed as Lofgren's syndrome via mediastinoscopy.
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    The Analysis of the Chest Tube Thoracostomies Performed in a Newly Established Hospital of a Medical School
    (Derman Medical Publ, 2015) Alar, Timucin; Gedik, Ismail Ertugrul
    Aim: We have analyzed the chest tube thoracostomies (CTT) performed in our Thoracic Surgery clinics of our newly established medical school hospital. Material and Method: The medical records of 130 patients to whom CTT were performed by the Thoracic Surgery Clinics of the Canakkale Onsekiz Mart University from December 2009 to July 2013 were retrospectively analyzed. Results: 102 patients (78%) out of 130 were male and 28 (22%) were women. Mean age of the patients were 58.9 +/- 20.4. 19% (n:25) of these patients were diagnosed at our clinics and the remaining 81% (n:105) were consultated from other clinics The most common indication of CTT was pleural effusion (35%, n:45). The mean fluid drainage of the patients with pleural effusions for various reasons (63%, n:84) were 1462.80 +/- 1054.46. The mean air drainage time for the patients with pneumothorax for various reasons (37%, n:46) were 5.8 +/- 3.1 days. There was only one complication (0,8%) in these 130 patients which was the intraparanchymal drain placement. Discussion: As a procedure that is usually performed under emergency conditions CTT has a high potential for development of serious complications and thus increasing the importance of resident doctor training in Thoracic Surgery clinics. CTT has a low rate of complications when performed with the right indication, at the appropriate location and in devotion to the surgical principles; can increase the importance of the Thoracic Surgeons in the medical centers that they are working at and can also increase the relationship of the Thoracic Surgery clinics with the other clinics.
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    The effects of analgesic treatment and chest physiotherapy on the complications of the patients with rib fractures that arise from blunt chest trauma
    (Turkish Assoc Trauma Emergency Surgery, 2020) Alar, Timucin; Gedik, Ismail Ertugrul; Kara, Murat
    BACKGROUND: This prospective study aims to investigate the effect of chest physiotherapy and analgesic therapy on the possible complications of isolated rib fractures attributable to blunt thoracic trauma, such as hemothorax and pneumothorax. METHODS: Patients who presented to Canakkale Onsekiz Mart University School of Medicine Hospital's Emergency Department and Thoracic Surgery outpatient clinics within the first 24 hours of the post-traumatic period and did not have additional intrathoracic complications at presentation with blunt thoracic trauma and who were diagnosed with isolated rib fractures were enrolled in this prospective research study. The groups were designated as the patients who would receive analgesic treatment only (Group A) and the patients who would receive chest physiotherapy and analgesic treatment together (Group B). Patients who had first and second rib fractures or three or more rib fractures and who did not have additional organ injury were hospitalized in the Thoracic Surgery clinics; patients who had other organ trauma were hospitalized in related clinics. Patients were reassessed on their seventh and 30th post-traumatic days with physical examination and radiologic studies. RESULTS: The mean age of the 114 patients were 56.3 +/- 16.4 (22-87). There were 37 (32.5%) women and 77 (67.5%) men. Each group included 57 patients. The most common form of trauma was the same-level falls (31.6%). The mean number of rib fractures of all participants was 2.6 +/- 0.7 (1-10); the median number was 1.5. Fifty-two (45.6%) patients were hospitalized. The mean length of stay was 4.0 +/- 1.1 days. At the end of their treatment and follow-up periods, pleural effusion was found in 28 patients (24.6%) out of 114 enrolled at the side of trauma. Group B had a higher number of patients with pleural effusion (43.9%) than group A (5.3%). We performed tube thoracostomy in four patients, all of which were in group B (p<0.05). CONCLUSION: As a result of this study, chest physiotherapy maneuvers have increased the incidence of late hemothorax in patients with three or more isolated rib fractures. Also, minimal hemothoraces (<300 ml) may spontaneously regress, and no additional surgical treatment are required if the proper follow-up procedures are performed. It is advisable to hospitalize the blunt thoracic trauma patients who have three or more rib fractures and who are planned to undergo chest physiotherapy and or are prone to develop additional complications because of possible risks.