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Aim: The study-cohort aims to assess PET-CT's correlation with adenocarcinomas' subtypes and propose a scoring system for mediastinal lymph nodes staging. Material and Method: The patient cohort is a multicenter, retrospective analysis of 268 patient that underwent surgery for NSCLC adenocarcinoma. Preoperative PET-CT results for mediastinal lymph node staging was pathologically confirmed on tissue specimens obtained at anatomical resection. Statistical evaluation of PET CT, radiological and pathological outcomes were performed on all subgroups. Results: The low FDG affinity in the lepidic pattern was statistically significant in the study (p

Aim:Traumatic rib fractures are a common injury in the trauma population and may cause severe pain in cases of both isolated rib fractures and chest injuries. The aim of our study was to compare the early pain control of intercostal block with that of intravenous analgesia + intercostal nerve block in patients with rib fractures admitted to the emergency department due to blunt thoracic trauma.Materials and Methods:Patients admitted to the emergency department due to blunt thoracic trauma in a tertiary medical facility were evaluated retrospectively. Forty-eight patients were included in the study. The patients were divided into two groups: on in which only intercostal nerve block was performed and another in which intravenous analgesia + intercostal block were performed concurrently.Results:Nine patients (18.7%) were given only intercostal block, while 39 patients (81.3%) were given intravenous analgesia + intercostal nerve block. Considering the early pain results of group A (intercostal nerve block) and group B (intravenous analgesia + intercostal nerve block), significant improvement was observed in group B in terms of pain results after the first 15 minutes.Conclusion:We conclude that the combination of intravenous nonsteroidal anti-inflammatory drugs or opioid derivatives and intercostal nerve block would be an effective combination in pain control in patients with rib fractures. In addition, intercostal nerve block would be beneficial in pain control and increase respiratory efficiency in patients with rib fractures, since it is both easy to apply and accelerates healing by providing effective analgesia. Due to these positive effects, we believe that it reduces the duration of hospital stay and would offer great advantages in terms of efficiency and cost.

Introduction:To investigate the relationship between morphometric variants of the cochlear nerve (CN) and the hearing level. To investigate the confounding effects of age, sex, and audiometric variables on the relationship between CN morphometrics and hearing loss, if present.Methods:Audiological data and magnetic resonance imaging findings of 127 patients with asymmetrical sensorineural hearing loss (ASNHL) were reviewed retrospectively. According to pure tone average (PTA) frequencies of each ear, difference above 25 dB were accepted as ASNHL. The vertical (Vd) and horizontal diameters (Hd) and the cross-sectional area (CSA) of the CN were measured.Results:The difference in CSA and Vd between ears showed a negative correlation with age. The mean CSA was 1.57 in AE and 1.60 in NE. Mean Hd was 1.00 in AE and 1.00 NE. Mean Vd was 1.40 in AE and 1.50 in NE. There was no correlation between the difference ratios of thresholds and CN diameter parameters. There was no significant correlation of CSA, Vd, and Hd with PTA thresholds at each frequency.Conclusion:Aging is associated with losses in Vd diameter and CSA. The degree of hearing loss was not correlated with the morphometric features of the CN. The morphometry of the CN should be interpreted together with the etiology of hearing loss.

Background: In this study, we present our experiences with local injections of triamcinolone and prilocaine in patients diagnosed with Tietze syndrome. Methods: Between January 2016 and January 2019, a total of 28 patients (12 males, 16 females; median age: 33 years; range, 21 to 51 years) who were diagnosed with TS in our clinic were retrospectively analyzed. Triamcinolone hexacetonide and prilocaine hydrochloride were injected into painful joints. At first week, pain sensation of the patients was recorded using the Pain Rating Scale developed by the British Pain Society. Pain was also assessed at one, two, and three weeks after injections qualitatively and based on physical examination. Results: At one week, the pain severity before the local injection treatment was above average the pain-related discomfort rates, and the response was quite favorable after the treatment (p=0.005 and p=0.001, respectively). A statistically significant rating was observed for treatment response and success (p=0.003). Totally 75% of the patients experienced more than 70% reduction in pain level after the injection. Conclusion: Our treatment approach involving injection of a mixture of steroid and a local anesthetic provides a rapid relief from pain, irrespective of age, sex, or employment status in patients diagnosed with Tietze syndrome.

The co-existence of right ventricular dysfunction (RVD) in heart failure patient with reduced ejection fraction (HFrEF) is an independent maker of poor prognosis. A novel right ventricular hemodynamic composite measure is the pulmonary artery pulsatility index (PAPi), which is the pulmonary artery pressure gradient ratio. It is a strong predictor of RVD in patients with acute inferior myocardial infarction and patients undergoing left ventricular assist device (LVAD) implantation. However, little is known about its prognostic value in patients with HFrEF.Between September 2010 and July 2013, 172 patients with HFrEF admitted to the tertiary hospital were included in this analysis. We carried out a cardiac catheterisation for each patient, at baseline. Subsequently, we evaluated both PAPi and the other hemodynamic parameters with longitudinal follow-up of adverse outcomes such as cardiac mortality, LVAD, and heart transplantation (HTx).During a median follow-up period of 52 months we observed 50 cardiac deaths, 12 LVAD implantations and 10 HTx. A threshold for PAPi value of 2.82 was ascertained (Area: 0.76,In patients with HFrEF, a low PAPi value (2.82) was associated with increased cardiac mortality risk.

Amaç: Plevral aralıkta serbest hava görülmesi olarak tanımlanan pnömotoraksın sekonder sebepleri arasında en sık görülen patoloji Kronik obstruktif akciğer hastalığı (KOAH)’dır. KOAH’lı hastalarda sınırlı pulmoner rezerv nedeniyle pnömotoraks tedavisinin hızlı ve etkin olması önemlidir. Bu çalışmanın amacı, KOAH hastalarında gelişen pnömotoraksta otolog kan ile yapılan plörödezis işleminin sonuçlarını incelemektir. Gereç ve Yöntem: Kliniğimizde şubat 2017-şubat 2020 yılları arasında KOAH hastalığı olan ve pnömotoraks sebebiyle tüp torakostomi uygulanan ve otolog kan ile plöredezis işlemi yapılan olgular incelendi. Yaş, cinsiyet, sigara öyküsü, plöredezis sonrası semptomlar, nüks oranları, komplikasyon ve hastanede yatış süreleri açısından retrospektif olarak değerlendirildi. Bulgular: Yaş ortalaması 65,5 (54-76) olan 27 olgunun tamamı sigara içen erkek hastalardan oluşmaktaydı. Olguların hava kaçağı ortalama süresi 9 (5-16) gün, ortalama yatış süresi 12 gün (8-19), 3 aylık takiplerindeki nüks oranı ise %11.1 olarak (3 olgu) bulundu. Olguların hiçbirinde plöredezis sonrası allerjik reaksiyon, enfeksiyon ve ağrı gözlenmedi. 1 olguda (%3,7) işlem sonrası cilt altı amfizemi, 5 olguda (%18,5) dispne gelişti. Olgularda yaş arttıkça işlem sonrası saturasyon düşüklüğünün anlamlı olarak arttığı izlendi. Saturasyon değerinin artmasının dispne şikayetini anlamlı şekilde azalttığı, yüksek saturasyon değerlerinin 3 aylık periyotta nüks oranını anlamlı şekilde azalttığı gözlenmektedir (p

Uyku bozukluklarindan biri olan uyku apnesinin tanisi, geleneksel olarak bireylerin uyku laboratuvarlarinda polisomnografi (PSG) cihazina baglanmasi ve uyku suresi boyunca izlenen 14 farkli parametre ile ilgili olcumlerin degerlendirilmesi sonucunda konulmaktadir. Ancak bu durum, hareket kisitlamali ve yasli kisiler icin onemli zorluklar olusturmaktadir. Bu calismada, belirtilen tipteki kisilerin ileri tetkikler icin hastanedeki uyku laboratuvarlarina gelmelerinin gerekli olup olmadigi kararinin verilmesi konusunda hekimlere yardimci olabilecek bir karar destek yazilimi (KDY) gelistirilmistir. KDY’de ilgilenilen parametre, sadece kandaki oksijen saturasyonudur (SpO2). SpO2’nin secilme sebebi, solunumla ilgili olmasi ve parmaga takilan bir cihazla kolaylikla olculebilmesi nedeniyle kisinin uyku konforunu bozmamasidir. Amerikan Ulusal Uyku Arastirmalari Kaynagi’na (National Sleep Research Resource, NSRR) ait Uyku Kalp Sagligi (Sleep Heart Health, SHH) veri setindeki 100 denekten alinan PSG cihazi ciktilari, Microsoft Structured Query Language (MS SQL) veri tabani sunucusuna aktarilmis ve MS SQL kullanilarak tasarlanan KDY ile incelenmistir. Bu inceleme sonucunda, “uyku apnesi riski yok” tespitinde, KDY’nin NSRR ile % 76 duzeylerinde eslesme oranlarina sahip oldugu gorulmustur. Bu sonuc, gelistirilen KDY’de, hekim kararlarini destekleme potansiyeli bulundugunu gostermektedir.

The aim of our study is to compare 2 prostate fusion biopsy models in terms of accurate target sampling. One hundred patients who had Prostate Imaging-Reporting and Data System score 3, 4, or 5 lesions (lesion diameter, >5 mm in long axis) in multiparametric-magnetic resonance imaging and prostate-specific antigen levels between 3 and 10 ng/mL were enrolled in the study. All patients were biopsy naive. Two groups were composed with 50 patients each. Group 1 patients had cognitive fusion (CF) biopsy, and group 2 had magnetic resonance-ultrasound fusion platform biopsy. After fusion biopsy, standard biopsy was also performed. Outcomes of histopathologic and demographic data were evaluated statistically. There were no statistical differences between the 2 groups in terms of age, prostate-specific antigen levels, prostate volume, and lesion length (P > 0.05). There was no statistically significant difference in sampling targeted lesions (P > 0.05). Also, no difference was found between the 2 groups in terms of random biopsy cancer detection rates (P > 0.05). There was no statistically significant difference between CF and magnetic resonance-ultrasound fusion in terms of cancer detection rates. For the experienced operators, we recommend lesions that are longer than 5 mm can be sampled using CF, an inexpensive and faster technique.

RATIONALE AND OBJECTIVES: The aim of our study was to evaluate whether there is any correlation between a histogram analysis of the pectoralis muscle derived from chest computed tomography (CT) and the mortality rate for COVID-19 pneumonia in the adult population. METHOD: Chest CT derived measurements were evaluated retrospectively for 217 patients with a diagnosis of COVID-19 pneumonia. Using a CT histogram analysis, we measured pectoralis muscle volume (PV) and pectoralis muscle density (PD). Patients were divided into groups first according to gender and then subgroups, which are age and outcome. RESULTS: The COVID-19 diagnoses were confirmed by RT-PCR testing, chest CT and clinical findings in 217 patients (108 men, 109 women), aged 21-92 years (mean 61 years). PD measurements were lower in the exitus group (p = 0.001) and in patients aged ≥65 than in those aged

Background: The aim of this study is to evaluate the epidemiological and demographic features, treatment types of patients with thoracic trauma, as well as the duration of hospital stay and the factors affecting mortality. Material and Methods: This retrospective cross-sectional study included patients who applied to the emergency room in a tertiary care hospital, between 2017–2019 and having thoracic trauma. Patients; age, gender, date of application, type of injury (blunt or penetran), arrival saturation, use of anticoagulants, type of injury, side of injury (right, left, bilateral) additional injury, hospitalization and mortality status were recorded. P < 0.05 was considered as statistically significant. Results: Total of 113 people were included in the study. The average age was 52.15 ± 20.3. The most common reason of applying to the hospital was falling with 50 patients. A negative weak correlation was found between saturation and age and hospital stay. In terms of pathology and gender, there was no statistically significant difference in mortality. Conclusion: As a result, in this study, thoracic trauma occurs mostly in men and due to falls and motor vehicle accidents, and the majority of injuries due to thoracic trauma can heal without follow- up or tube thoracostomy.

Objective: To compare intact and diseased ears for Eustachian tube (ET) length and width in patients with unilateral chronic otitis media (COM), and to assess the relationship between cholesteatoma spread, stapes erosion, lateral semicircular canal (LSCC) fistula and ET width and length retrospectively.Methods: Subjects with unilateral COM (122 subjects with 244 ears) who underwent surgery for cholesteatoma were evaluated retrospectively for this study. The width of the distal orifice of the bony segment and the length of the bony segment of the ET for both the diseased and healthy ear were measured. Subjects’ healthy and diseased ears were compared for ET length and width. The diseased sides were compared to assess the relationship between ET dimensions and cholesteatoma spread, stapes erosion and LSCC fistula.Results: The mean ET length and width in healthy and diseased ears was 11.38±1.7 and 1.43±0.37 mm, and 10.99±1.6 and 1.27±0.35 mm, respectively; the difference was statistically significant (p

Aim: Future projections suggest that more older people will be affected by non-small cell lung cancer (NSCLC) over the next years due to longer life expectancy and aging global population. Chronological age is used to define elderly. 70 years of age is the most commonly accepted lower limit of senescence since the majority of physiological changes occur after this age. The aim of the current study was to review demographic, epidemiological and clinical characteristics of patients over the age of 70 diagnosed with NSCLC who underwent pneumonectomy at our clinic in a retrospective manner. Methods: This cross-sectional study involved a retrospective assessment of 21 patients over 70 years of age who were diagnosed with NSCLC and underwent pneumonectomy between January 2010 and January 2020. Demographic data, symptoms, tumor types, localization of tumors, postoperative complications and stages of cancer were recorded in the database and statistically analyzed.Results: All 21 patients were male and had a mean age of 72.5 years. The presenting symptom was dyspnea in 23.8% of the patients, cough in 28.6%, hemoptysis in 19%, chest pain in 14.3% and weight loss in 4.8% of the patients and 9.5% of the cases were detected incidentally. The tumor types included squamous cell carcinoma (57.1%), adenocarcinoma (23.8%), adenosquamous carcinoma (14.3%) and large cell carcinoma (4.8%). Tumor site was the left lung in 81% and right lung in 19% of the patients. Early postoperative complications occurred in 5 (23.8%) patients. Three of these patients developed atrial fibrillation and two patients suffered hemorrhage. Postoperative tumor stages of the patients were stage 3a (47.6%), stage 2b (19%), stage 2a (14.3%), stage 1b (9.5%) and stage 1a2 (9.5%). Multidimensional scaling analysis showed an association between the type of tumor and smoking but no association was found between tumor type and family history (P=0.024, P=0.586, respectively).Conclusion: It should be kept in mind that surgical resection and even pneumonectomy which is associated with high mortality and morbidity can be successfully performed in older cancer patients through a good preoperative workup, tumor staging, assessment of the risk of mortality and the effects of comorbid conditions., Amaç: Uzayan yaşam süresi ve yaşlanan dünya nüfusu ilerleyen yıllarda daha fazla sayıda yaşlı küçük hücreli dışı akciğer kanserli (KHDAK) hastanın ortaya çıkacağını göstermektedir. Yaşlılık tanımlaması için kronolojik yaş kullanılmaktadır. 70 yaş fizyolojik değişikliklerin giderek artmaya başladığı dönem olması nedeniyle en çok kabul gören sınır olmuştur. Çalışmamızda; kliniğimizde KHDAK tanısı nedeniyle pnömonektomi uygulanmış 70 yaş üstü hastaların demografik, epidemiyolojik ve klinik özelliklerinin geriye dönük olarak incelenmesi amaçlanmıştır. Yöntemler: Kesitsel tipteki bu çalışmada, Ocak 2010 ile Ocak 2020 arasında KHDAK tanısı alan ve pnömonektomi yapılan 70 yaş üstü 21 hastanın retrospektif olarak değerlendirilmesi yapıldı. Demografik veriler, semptomlar, tümör tipleri, tümörlerin lokalizasyonu, postoperatif komplikasyonlar ve kanser evreleri veri tabanına kaydedildi ve istatistiksel olarak analiz edildi.Bulgular: Çalışmamızda yer alan 21 hastanın tamamı erkek ve ortalama yaş 72,5 idi. Hastaların %23, 8’i dispne, %28,6’ı öksürük, %19’u hemoptizi, %14,3’ü göğüs ağrısı, %4,8’i kilo kaybı şikayeti ile başvururken %9,5’i insidental olarak saptanmıştır. Tümör tipi %57,1 squamöz hücreli karsinom, %23,8 adenokarsinom, %14,3 adenosquamöz karsinom ve %4,8 large cell karsinom olarak tespit edilmiştir. Tümör %81 sol, %19 sağ akciğer yerleşimliydi. Postoperatif erken dönemde olguların 5’inde (%23,8) komplikasyon görülmüştür. Erken dönem komplikasyon görülen olguların 3’ünde atrial fibrilasyon, 2’sinde kanama olduğu görüldü. Hastaların postoperatif evreleri; %47,6’ı evre 3a, %19’u evre 2b, %14,3’ü evre 2a, %9,5’i evre 1b ve %9,5’i evre 1a2 idi. Çok boyutlu ölçekleme analizinde tümör tipi ile sigara kullanımının ilişkisi saptanmış ancak aile öyküsü ile tümör tipi arasında ilişki kurulamamıştır (sırasıyla P=0.024, P=0.586).Sonuç: Cerrahi rezeksiyon olarak morbidite ve mortalitesi yüksek olan pnömonektominin bile yaşlı hastalarda iyi bir preoperatif değerlendirme, evreleme, eşlik eden hastalıkların etkileri ve mortalite tayini ile başarılı bir şekilde uygulanabileceği bilinmelidir.

Mucoepidermoid carcinoma of the thymus is a rare malignant neoplasm of the anterior mediastinum. There are less than 30 cases described in the English literature. We report a case of a 77-year- old man with right chest pain. Thorax-CT scan showed a lobulated cystic mass having a focal solid portion with direct invasion of the adjacent pericardium in the anterior mediastinum. He underwent surgical resection for his anterior mediastinal mass via right thoracoscopic surgery without any complication. He had an uneventful recovery and was discharged on the sixth postoperative day.

If the heart is represented by a hydraulic pump, cardiac power represents the hydraulic function of the heart. Cardiac pump function is frequently determined through left ventricular ejection fraction using imaging. This study aims to validate resting cardiac power output (CPO) as a predictive biomarker in patients with advanced heart failure (HF). One hundred and seventy-two patients with HF severe enough to warrant cardiac transplantation were retrospectively reviewed at a single tertiary care institution between September 2010 and July 2013. Patients were initially evaluated with simultaneous right-sided and left-sided cardiac catheter-based hemodynamic measurements, followed by longitudinal follow-up (median of 52 months) for adverse events (cardiac mortality, cardiac transplantation, or ventricular assist device placement). Median resting CPO was 0.54 W (long rank chi-square = 33.6; p 0.0001). Decreased resting CPO (0.54 W) predicted increased risk for adverse outcomes. Fifty cardiac deaths, 10 cardiac transplants, and 12 ventricular assist device placements were documented. The prognostic relevance of resting CPO remained significant after adjustment for age, gender, left ventricular ejection fraction, mean arterial pressure, pulmonary vascular resistance, right atrial pressure, and estimated glomerular filtration rate (HR, 3.53; 95% confidence interval, 1.66 to 6.77; p = 0.0007). In conclusion, lower resting CPO supplies independent prediction of adverse outcomes. Thus, it could be effectively used for risk stratification in patients with advanced HF.

Mucoepidermoid carcinoma (MEC) of the lung is a rare form of lung cancer that is classified into low grade and high grade based on histological features. For Mucoepidermoid Carcinoma of the Lung, surgery is the most commonly used and most effective form of treatment. Surgical resection is the primary treatment for low-grade MEC with excellent outcomes but high-grade MEC is a more aggressive form of this malignancy.

Background: This study aims to compare the results of the open surgical approach versus endobronchial conical stent application in the treatment of extensive fistulas. Methods: Between December 2004 and April 2016, a total of 36 patients (34 males, 2 females; mean age 59.6±8.1 years; range, 40 to 72 years) with a bronchopleural fistula of ≥8 mm in diameter and underwent either conventional open surgery with stump-supported intercostal muscle flap or endobronchial ultra-flex expandable stenting were retrospectively analyzed. The demographic and clinical characteristics of the patients, operative data including the length of hospital stay, thoracic drainage time, and early mortality, and survival data were recorded. Results: The mean hospitalization time was 17.4±4.5 days for the bronchoscopic group and 22.5±6.7 days for the invasive surgery group (p=0.026). The median time to removal of thoracic drains was 15 (range, 10 to 30) days for the bronchoscopic group and 26 (range, 14 to 55) days for the surgical group (p=0.027). Early mortality rates of both approaches were in favor of the bronchoscopic approach (χ2=7.058; p=0.008). Two-year survival rate was 76.47% (n=13) in the bronchoscopic group and 70% (n=7) in the surgical group. There was no statistically significant difference in the survival rates between the two groups (χ2=0.132; p=0.716). Conclusion: Our study results suggest that bronchoscopic approach can be the first choice in the treatment algorithm of fistulas with a diameter of ≥8 mm presenting with empyema in selected cases.

BACKGROUND: There is supporting evidence that normal right heart function is crucial for the maintenance of normal overall hemodynamics. The heart can be described as a hydraulic pump, and cardiac power reflects the hydraulic function of the heart. The present analysis aimed to evaluate the prognostic value of right ventricular cardiac power output (RV-CPO) at rest in patients with advanced heart failure (HF). METHODS: Between September 2010 and July 2013, 172 patients with advanced HF referred to our hospital were included in this study. Performing right-sided and left-sided heart catheterization simultaneously for each patient at baseline, we evaluated the hemodynamics with longitudinal follow-up of adverse outcomes such as cardiac mortality, ventricular assist device placement, and cardiac transplant (HTx). RESULTS: The threshold RV-CPO at rest value was 0.15 Watts. Increased RV-CPO (> 0.15 Watts) was correlated with an increase in adverse outcomes. Over 52 months, we observed 50 cardiac deaths, 10 HTx, and 12 ventricular assist device placements. The prognostic value of RV-CPO remained significant after adjustment for age, gender, ejection fraction, cardiac output, mean arterial pressure, valvular heart disease, diabetes, body surface area and mineralocorticoid receptor antagonist medication dummy (hazard ratio 0.052, 95% confidence interval 0.006 to 0.406, p = 0.005). CONCLUSIONS: Higher RV-CPO at rest was an independent predictor of adverse outcomes. Therefore, RV-CPO could be integrated into the clinical evaluation used for individual risk stratification of patients with advanced HF in order to consider earlier HTx listing and/or earlier consideration for mechanical circulatory support device therapy.

Lymph node involvement is an important prognostic factor for non-small cell lung cancer. This study aims to investigate the relationship between lymph node involvement and the depth of chest wall invasion. Thirty-three patients who were operated on between 2015 and 2019 for radiologically and pathologically diagnosed chest wall invasion were retrospectively reviewed. Thirtytwo of the patients were male (97.3%) and 1 was female (2.7%) with an average age of 59.4 years. The tumor had a mean diameter of 5.81cm. The invasion was in the posterior part of the chest wall in 17 patients (51.5%), lateral in 11 (33.3%) and anterior chest wall in 5 patients (15.2%). Pleural, soft tissue and costal involvement was present in 32, 19 and 9 cases, respectively. A statistically negative correlation was observed between the depth of chest wall invasion and metastasis of lymph nodes no. 2, 4, 7, 10 and 11 (p:0.041, p:0.006, p:0.011, p:0.025, and p:0.009, respectively). As the invasion progresses towards the periphery, the result of the histopathological evaluation of the lymph nodes number 2, 4, 7, 10 and 11 was found to be benign in 73.1%, 64.6%, 91.4%, 87.5% and 64.9%, respectively. The correlation between the depth of invasion and lymph node metastasis, a subject of negligence up to now was evaluated. The findings presented herein have shown that in chest wall resections, the possibility of complete resection and the presence of lymphatic involvement which is an important prognostic marker are more important in terms of survival compared to the depth of invasion. [Med-Science 2021; 10(3.000): 934-8]

Pneumorrhachis is a rare phenomenon which may be caused by trauma, intracraneal infection, pneumomediastinum or iatrogenic factors. Presence of air in the spinal canal is reported in most cases. In this article, we report a case with PR in the spinal canal without any neurological deficit, which developed secondary to subcutaneous emphysema.

Transcatheter closure of mitral valve leaflet perforation is a very rarely performed and a difficult procedure for repairing the defect. Herein, we are the first to report on both the safety and feasibility of percutaneous retrograde transcatheter closure of anterior mitral valve leaflet perforation with an AMPLATZER (TM) Duct Occluder II (6 mm x 6 mm; ADO II; Abbott Vascular, IL, USA) device in a 19-year-old patient with a severe mitral valve regurgitation following cardiac surgery., NA

BackgroundTigertriever (Rapid Medical, Yoqneam, Israel) is a new design of stent retriever.PurposeTo evaluate the feasibility, safety, and efficacy of the Tigertriever in patients with acute ischemic stroke who have undergone mechanical thrombectomy.Materials and methodsTwo different techniques—namely, standard unsheathing (SUT) and repetitive inflation-deflation (RID) techniques, were used. Modified Thrombolysis in Cerebral Infarction (mTICI) scores of 2b and 3 were considered as successful recanalization.ResultsA total of 61 thrombectomy procedures with Tigertriever were retrospectively evaluated. The mean age of patients was 60.7 years and their National Institutes of Health Stroke Scale score was 14.7. Overall, the percentage of patients with a mTICI score of 0, 2b, and 3 was 24.6, 26.2, and 49.2, respectively. Successful recanalization and first-pass success rates were 75.4% and 37.7%, respectively. There were no statistical differences between the results of the SUT and RID techniques. No vessel rupture, dissection, or device detachment was observed. The number of patients with a good clinical outcome (modified Rankin Scale score 0–2) was 17 (27.9%).ConclusionOur results showed that the Tigertriever device is safe and efficient for mechanical thrombectomy.

The increase in city populations and the rise in requests about healthcare services created a new area called Smart Healthcare applications. Most of the smart healthcare implementations are used in systems and their components concerning remote control of chronic illnesses. Currently, hospital and doctor visits take a big part in healthcare services for chronic patients. It can be predicted that remote health checks will be easily done for those patients in the near future. In our work, we have developed a decision support system that can be used in remote-monitoring the oxygen saturation and pulse rate values of a patient. In this system, an Android smart phone, a portable and wearable pulse oximeter, an Android Studio 2.2.2 version mobile software development kit have been used. Furthermore, the designed system contains android mobile application, Microsoft SQL database and Microsoft Visual Studio programs. The web interface created with Microsoft Visual Studio is used in real-time transmission of oxygen saturation and pulse rate values to a central patient control system where instantaneous saving of values to the Microsoft SQL database is performed. The system designed in this work has an important potential for smart healthcare applications that will be used in remote control of chronic illnesses.

Data mining is used in many different areas. But the most important of these is the use of biomedical data in data mining. The results obtained from these data contribute to the pre-detection, prevalence and treatment of the diseases. Decision trees are one of the important tools that enable accurate assessment of these biomedical data. There are many applications that use decision trees such as Weka, R, Rapid Miner, Knime and Orange. Whether these practices correctly apply decision trees is of particular importance in terms of biomedical data. In this study, biomedical datasets taken from UCI Machine Learning Repository were classified by C4.5 algorithm. Data mining applications, which are widely used in the market for classification, have been selected. The accuracy parameter is used for the analysis. This study aims to reach the conclusion which application will give more accurate results about not analyzed biomedical datasets.

A 24-year-old primigravid woman at 28 weeks of gestation was admitted to the hospital because of drug-refractory atrial tachycardia and heart failure. The arrhythmia did not respond to drug therapy and electrical cardioversion. Since tachycardia was intractable and had potentially life-threatening consequences for mother and foetus, it was decided to ablate the tachycardia after a multidisciplinary meeting. During the procedure, maternal hypotension occurred, consequently causing persistent foetal heart rate reduction. Radiofrequency ablation was immediately cancelled and emergency caesarean section was carried out. After 72 hours after the caesarean-section, successful RF ablation could be performed. Mother was discharged on the seventh postoperative day. The newborn was hospitalised until having reached 2500 g and he was discharged in good condition. Mother’s left ventricle systolic function significantly improved and no atrial tachyarrhythmia was observed on the sixth month follow-up visit.

Aim: T1 patients who were operated due to non-small cell lung cancer (NSCLC)were evaluated retrospectively. The objective of this study was to evaluate metastatic lymph node status in T1 tumors and to discuss staging approaches in these tumors.Material and Methods: A total of 217 patients who met specified criteria between May 2012 and May 2019 were included in the study. Patients operated due to NSCLC who have a tumor size 3 cm were evaluated in terms of age, gender, preoperative diagnostic methods, thorax CT and PET-CT examinations, size, anatomic localization and histopathologic type of tumors, excised mediastinal lymph nodes and pathology results.Results: Of total 292 lymph node stations sampled in patients with adenocarcinoma, 257 (89.73%) were reported as benign and 30 (10.27) as malignant according to pathologic results. Of total 316 lymph node stations sampled in patients with squamous cell carcinoma, 298 (94.3%) were benign and 18 (5.7%) were malignant.N2 positivity was found in 40 (18.43%) of the 217 patients.Conclusion: Mediastinoscopy should be performed for staging in the presence of a tumor size above 2 cm, histopathological type of adenocarcinoma, high mass SUVmax values, lymph node with radiological growth and pathological involvement.

We report the case of a 51-year-old woman who presented with stable angina pectoris and Canadian Cardiovascular Society class II functional capacity. An electrocardiogram during a treadmill exercise test showed substantial ST-segment depression in the inferolateral leads. Coronary angiograms revealed an anomalous origin of the left main coronary artery from the opposite sinus of Valsalva and an interarterial course between the ascending aorta and pulmonary artery. Although this phenomenon is dangerous, the patient refused further examination. We discuss the diagnosis and treatment of patients who have an anomalous origin of a coronary artery from the opposite sinus of Valsalva.

Aim: Postpneumonectomy empyema is one of the most difficult clinical conditions in thoracic surgery. There is a wide range of conventional treatment options ranging from tube thoracostomy, antibiotic irrigation to open-window thoracostomy. Vacuum-Assisted Closure (VAC) therapy is also among the treatment options. In our study we aimed to compare the outcomes and efficiency of conventional treatment procedures and VAC.Material and Methods: Eighteen male patients (average age 54.8± 18.68), who were diagnosed with postpneumonectomy empyema between July 2012 and November 2014, were divided into two groups. Nine patients (Group I) have been treated with conventional procedures, while the other nine patients (Group II) have been treated with VAC.Results: Five patients in the Group I were cured in an average of 9.6 months. Four patients underwent additional surgical intervention and they remained in the empyema clinic for 12 months in the follow-up period. Seven patients in the Group II were cured during the follow up period of an average of 14.8 months. Two patients who developed bronchopleural fistula remained in the empyema clinic. Average length of hospital stay is 109.3 days for the Group I and 63 days for the Group II. The treatment of the Group II has been found more successful than the Group I in terms of pain status assessment, patient’s comfort and postoperative cosmetic appearance.Conclusions: VAC group success rate has been found higher in terms patient’s comfort, the length of hospital stay and duration of empyema. Further studies are required to establish the success of this procedure.Keywords: Postpneumonectomy empyema; Vacuum-Assisted Closure (VAC); Thoracostomy.

Objectives We aimed to evaluate the electroencephalography (EEG) and diffusion weighted magnetic resonance (DWMR) findings obtained after a seizure in the acute period and to find out whether DWMR had any contribution to determine lateralization of epileptogenic activity. Methods Consecutive 43 patients with a seizure admitted to emergency department between July 2016 and February 2017 were evaluated, retrospectively. Patients whose seizures occurred in the last three days were included in the study. Demographic and clinical features, EEG and radiologic findings of the patients were evaluated. Results Mean age of total 43 patients was 48.12 ± 29.7 (18–80) years and 26 (60.5%) of them were female, 17 (39.5%) were male. Patients were divided into 3 groups regarding the classification of epileptic seizures; generalized (n = 17), partial (n = 23) and unclassified seizures (n = 3). Ten patients (23.3%) had the diagnosis of epilepsy previously. Abnormalities in EEG and DWMR were detected in 55.8% and 16.3% of the patients, respectively. In addition, 6 patients of the 7 with MR abnormalities were from partial seizures and 1 patient from generalised seizures groups. Areas of diffusion restriction were consistent with the localization of EEG abnormalities in 4 out of 7 patients. Discussion EEG is a valuable tool in supporting the diagnosis of epilepsy and classification of seizures. DWMR may be used in epilepsy patients to detect the areas that could be the cause of the epileptogenic activity in the post-ictal acute phase. Conclusions Further studies with higher number of patients may investigate the relationship between EEG and DWMR abnormalities. Significance This study may draw attention to relationship between neurophysiological and radiological findings in the acute period after a seizure.

Testicular cancer is the most common malignancy in young men (15-29 years old). Combination therapy with bleomycin, etoposide, and cisplatin has been the standard first-line treatment for testicular metastatic disease. We present a case of multicoronary thrombi causing acute inferior myocardial infarction in a patient who recently received chemotherapy for testicular tumor.