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Sevket Ozkaya,1 Adem Dirican,2 Sule Ozbay Kaya,3 Rabia C Karanfil,3 Merve G Bayrak,4 Ozgür Bostancı,5 Ferah Ece1 1Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, 2Department of Pulmonary Medicine, 3Department of Physical Therapy and Rehabilitation Clinic, Samsun Medicalpark Hospital, 4Department of Pulmonary Medicine, Samsun Chest Diseases and Thoracic Surgery Hospital, 5Academy of Sports, Ondokuzmayis University, Samsun, Turkey Abstract: Maximal inspiratory pressure (MIP) is a marker for assessing the degree of respiratory muscle dysfunction. Muscle dysfunction represents a pathophysiological feature of chronic obstructive pulmonary disease. We aimed to determinate the MIP value in patients with airway obstruction, to evaluate the change in MIP with bronchodilator drug, and to show the relationship between the changes in MIP and disease characteristics. We evaluated 21 patients with airway obstruction at the Department of Pulmonary Medicine, Samsun Medicalpark Hospital, Samsun, Turkey. We performed pulmonary function tests, measurement of MIP values, and reversibility tests with salbutamol. The baseline spirometry results were: mean forced vital capacity (FVC), 3,017±1,020 mL and 75.8%±20.8%; mean forced expiratory volume in 1 second (FEV1), 1,892±701 mL and 59.2%±18.2%; FEV1/FVC, 62.9%±5.5%; peak expiratory flow, 53%±19%. The pre-bronchodilator MIP value was 62.1±36.9 cmH2O. The reversibility test was found to be positive in 61.9% of patients with salbutamol. The absolute change and percentage of change in FEV1 were 318±223 mL and 19.8%±16.7%, respectively. The MIP value was increased by 5.5 cmH2O (8.8%) and was 67.7±30.3 cmH2O after bronchodilation. There was no significant relationship between age, FEV1, reversibility, and change in MIP with bronchodilator. However, the increase in MIP with bronchodilator drug was higher in patients with low body mass index (

Background: Although pneumonectomy has relatively high mortality and morbidity rates, it remains valid in the surgical treatment of lung cancer. This study aims to evaluate the prognostic significance of postoperative complications after pneumonectomy and demonstrate the risk factors related to early postoperative complications., Methods: Patients who underwent pneumonectomy for non-small cell lung cancer between January 2008 and May 2021 were included in the study. Factors related to the development of early postoperative complications and overall survival were evaluated by univariate and multivariate analyses., Results: A total of 136 patients were included in the study. Early postoperative complications were seen in 33 (24.3%) patients and late postoperative complications in 7 (5.1%) patients. The amount of cigarette smoking, and the operation side were the independent variables that affect the development of early postoperative complications. In multivariate analysis, smoking amount and pericardial invasion were associated with the development of postoperative hemorrhage, and advanced age was associated with the development of postoperative pneumonia., Conclusions: Early postoperative complications have a negative effect on the prognosis after pneumonectomy therefore careful patient selection and preoperative risk assessment are essential to minimize the occurrence of complications and improve patient outcomes., Trial Registration: This observational study was approved by the (Ethical Committee of Dr. Suat Seren Chest Diseases and Chest Surgery Education and Research Center) Institutional Review Board of our center (E-49109414-604.02.02-218625439)., (© 2024. The Author(s).)

Nodal metastasis status is an important parameter affecting the prognosis in lung cancer. Although surgical treatment is possible in most cases of N1 positive non-small cell lung cancer, this group of patients is clinically, radiologically and histologically heterogeneous. The aim of our study is to investigate the prognostic factors affecting survival in patients with pT1-2 N1 who underwent lung resection. From January 2010 to December 2019, patients who underwent lobectomy, bilobectomy or pneumonectomy for pT1-T2 N1 NSCLC in our center were included in the study. The preoperative, intraoperative and postoperative data of the patients were recorded by accessing the patient files and hospital records. The mean follow-up time was 39.8 months. The mean overall survival was 73.8 ± 3.6, and the mean disease-free survival was 67.5 ± 3.8. In multivariate analysis, age, N1 nodal metastasis pattern (occult vs obvious) and histology were found as independent variables affecting survival. In our study, age, histology, and clinical N1 status were found to be independent variables effective on overall survival., (© 2023. Italian Society of Surgery (SIC).)

Background: Bronchopleural fistula (BPF) is a serious complication with high mortality and morbidity that can be seen after lung resections. Although several methods have been described to prevent postoperative BPF it is still unclear which method is the best. In this study, we have used tymopericardial fat flap (TPFF) to cover the bronchial stump in patients after pneumonectomy and aim to show its feasibility and efficacy to prevent BPF., Methods: Between January 2013 and June 2021, 187 patients with lung cancer underwent pneumonectomy at our institution. Among them, 53 patients underwent bronchial stump coverage with TPFF. In other 134 patients there wasn't used any coverage method. Patient characteristics, preoperative status, surgical procedures, perioperative course, pathological findings, and long-term prognoses were evaluated retrospectively., Results: Postoperative BPF was observed in 16 (%8.5) patients. It was observed that TPFF was applied in only 1 of the patients who developed BPF. A statistically significant difference was detected between TPFF-coverage with non-coverage groups in terms of postoperative BPF rates (p = 0.044). Other factors associated with the development of postoperative BPF in univariate analysis were right sided pneumonectomy, and re-operation., Conclusion: Bronchial stump coverage with TPFF is a feasible and effective method to prevent postpneumonectomy BPF., (© 2022. The Author(s).)

Diabetes mellitus, which causes many complications, also adversely affects reproductive system in men. Studies reported that natural antioxidants are effective in reducing important complication risks caused by diabetes. Carvacrol is an antioxidant phenolic monoterpene compound with therapeutic effect in various diseases found in essential oils of aromatic plants such as pepper, wild bergamot and thyme. We aimed to investigate the effects of carvacrol on diabetes-induced reproductive damage in male rats by evaluating the Nrf2/HO-1 pathway and Nf-kB-mediated apoptosis/inflammation and spermatological parameters. For this purpose, 74 Wistar albino male rats were used. The diabetes model was performed using single-dose intraperitoneal injection of streptozotocin 55 mg/kg. Rats were fed with carvacrol 75 mg/kg/daily/gavage for 4 and 8 weeks. Rats were divided into four groups: control group, diabetic group, carvacrol group which fed with carvacrol and the diabetic group which fed with carvacrol. It was determined that carvacrol significantly decreased malondialdehyde levels, Bax,COX-2,Nf-kB protein expression levels, Bax/Bcl-2 ratio and significantly increased glutathione peroxidase, catalase activities, Bcl-2, Nrf2,HO-1 protein expression levels and it was determined that had a positive effect on spermatological parameters. In conclusion, the negative effects of diabetes in the male reproductive system can be prevented and/or reduced by giving carvacrol., (© 2020 Wiley-VCH GmbH.)

Competing Interests: None

Background: VATS lobectomy is a recommended surgical approach for patients with early-stage lung cancer. However, it is still controversial in locally advance disease. This study was conducted to compare intraoperative and postoperative results of VATS and thoracotomy in patients with tumors greater than 5 cm., Methods: From January 2014 to December 2018, 849 patients underwent lobectomy or pneumonectomy for the treatment of non-small-cell lung cancer at our center. The inclusion criterion of this study was patients who underwent anatomic lung resection for lung cancer with tumors larger than 5 cm((≥ T3). The patients were divided into two groups: those who underwent video-assisted thoracoscopic surgery (n = 24) and those who underwent thoracotomy (n = 36). Patient characteristics, intraoperative and postoperative results were evaluated by review of the hospital records., Results: In the VATS group, mean drainage time and postoperative length of hospital stay were significantly shorter than the thoracotomy group. Kaplan-Meier survival curves showed that overall and recurrence-free survival was longer in the VATS group and this result was statistically significant., Conclusions: According to the results of this study, we emphasize that VATS is a feasible surgical procedure for tumors larger than 5 cm.

Objectives: The effect of non-steroidal anti-inflammatory drugs (NSAID), mostly used for postoperative analgesic purposes for wound healing, is still a matter of debate. Our goal was to evaluate the effects of the most widely used NSAID and corticosteroids after surgical operations on tracheal wound healing in an experimental rat model., Methods: Thirty-nine male Wistar albino rats were included in this study. Tracheotomy was performed in 32 rats; then they were divided into 3 groups. After the first day, the animals in group 1 were treated with an NSAID (diclofenac 10 mg/kg/day) (NSAID, n = 12) for 7 days; the animals in group 2 were treated with a corticosteroid (dexamethasone, 2 × 0.1 mg/kg/day) (steroid, n = 10) for 7 days; the animals in group 3 (control, n = 10) were not given any medications. For a fourth group (histological control, n = 7), in order to evaluate normal morphological and histological characteristics, neither surgery nor medication was used. Five rats were eliminated from the study (2 rats in the NSAID group died and 3 rats in the steroid group developed local wound infections). The drop-out rate was 12.8%. Histological characteristics, inflammation, fibrosis, necrosis, neochondrogenesis, neovascularization and epithelization were evaluated in 34 rats. Non-parametric tests were used for statistical analysis., Results: Inflammation, vascularization and number of fibroblasts and chondrocytes were significantly higher in the control group than in the histological control group. There was some reduction in all parameters except vascularization in the NSAID group (P > 0.05). When the steroid group was compared to the NSAID group, inflammation (P < 0.05), vascularization and number of chondrocytes (P > 0.05) were more suppressed in the steroid group. The number of fibroblasts increased in the steroid group (P > 0.05)., Conclusions: Steroids and NSAID may have negative effects on tracheal wound healing, probably by suppressing inflammation and fibroblast proliferation. NSAID was mostly used postoperatively for analgesic purposes and should be avoided., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

In this study, it was aimed to investigate the changes in testicular tissue and cell count, testicular oxidative stress and some metabolic blood parameters of male broiler Japanese quails fed with high energy diet and milk thistle (Silybum marianum) seed. One hundred-twenty male 15-day-old Japanese quail chicks were divided into 4 equal groups with 30 each. The applications in each group were repeated 3 times with 10 animals each. Control group was fed with basal diet. Milk thistle seed group was fed with diet including 1% milk thistle seed. High energy diet group was fed with high energy diet including 10% corn syrup. High energy diet + milk thistle seed group was fed with high energy diet including 10% corn syrup along with 1% milk thistle seed. The feeding period in all groups was 35 days. When the quails reached 50 days old, a total of 48, 12 from each group (4 from each replication) were euthanized and blood samples and testes were collected. Compared with the control group, significant increases in body weight, serum cholesterol and glucose level, aspartate aminotransferase activity and testicular malondialdehyde level; however, significant decreases in serum testosterone level, testicular glutathione peroxidase activity, counts of round and elongated spermatid and sperm as well as histopathologically, significant decreases in seminiferous tubular diameter and seminiferous epithelium thickness, and marked disorganization in germinal cells were determined in quails fed with high energy diet. It was observed that almost all of the disturbances in testicular tissue, cell number, oxidant-antioxidant balance and metabolic blood parameters caused by feeding with high energy diet were significantly prevented by supplementation of milk thistle seed to the diet with high energy. On the other hand, alone milk thistle seed and high energy diet + milk thistle seed administrations decreased body weight in comparison to control and high energy diet groups. As a result, feeding with high energy diet causes disturbances in testes of male quails by affecting liver metabolic functions and testicular oxidant-antioxidant balance, but milk thistle seed addition to diet plays a protective role., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported, and authors declare that no financial or other conflict of interest., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Metal endoclips are frequently utilized in surgical procedures. Within the medical literature, metal endoclip migration following general surgical procedures is a widely studied complication. However, examples of thoracic metal endoclip migration are, as yet, absent in the medical literature. This case study seeks to provide the first clear example of such thoracic metal endoclip migration., (© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)

The aim of this study was to investigate whether pomegranate juice (PJ) consumption has an ameliorating effect on carbon tetrachloride (CCl4)-induced sperm damages and testicular apoptosis associated with the oxidative stress in male rats. The study comprised of four groups (groups 1-4). Group 1 received olive oil + distilled water daily; group 2 was treated with 5 ml/kg PJ + olive oil daily; group 3 was treated with 0.25 ml/kg CCl4 dissolved in olive oil, weekly + distilled water daily; and group 4 received weekly CCl4 + daily PJ. All administrations were performed by gavage and maintained for 10 weeks. CCl4 administration caused significant decreases in body and reproductive organ weights, sperm motility, concentration and testicular catalase activity, significant increases in malondialdehyde (MDA) level, and abnormal sperm rate and apoptotic index along with some histopathological damages when compared with the control group. However, significant ameliorations were observed in absolute weights of testis and epididymis, all sperm quality parameters, MDA level, apoptotic index, and testicular histopathological structure following the administration of CCl4 together with PJ when compared with group given CCl4 only. In conclusion, PJ consumption ameliorates the CCl4-induced damages in male reproductive organs and cells by decreasing the lipid peroxidation., (© The Author(s) 2013.)