Pulmonary hydatid disease is difficult recognized in children.

PURPOSE: Pulmonary hydatid disease is a significant health problem for children in endemic areas. Pulmonary hydatid disease is more frequent than hepatic hydatid disease in children. The aim of this study was to evaluate the characteristics of pulmonary hydatid disease for children in our province which is endemic for echinococcosis. PATIENTS AND METHODS: This study was performed retrospectively between 2007 and 2012 by reviewing the medical records of patients (≤17 years) who were diagnosed with pulmonary hydatid disease. The medical records of these patients were evaluated with respect to the demographic characteristics of patients, management strategies, length of hospital stay, and outcomes. RESULTS: A total of 120 (52.9% boys and 46.3% girls) patients with the diagnosis of pulmonary hydatid disease were enrolled in this study. The mean age was 10.15 ± 3.93 years. The significant numbers of patients were admitted with a ruptured hydatid disease and managed with lung preservation. The mean follow-up was 11.3 ± 3.8 (3-24) months. Recurrence was detected in three patients during follow-up. CONCLUSION: Pulmonary hydatid disease is usually symptomatic. Hydatid disease must be considered in differential diagnosis while evaluating thoracic lesions in endemic areas.

A pilot experimental study of a catheter to facilitate treatment for penetrating cardiac injury.

BACKGROUND/AIM: Penetrating heart injuries result in high mortality. We designed a new catheter to facilitate the treatment of penetrating cardiac injuries and provide more effective initial bleeding control and fluid replacement. MATERIALS AND METHODS: The cardiac injury model was applied to 8 female 1-year-old Sus domesticus pigs. Subjects were grouped according to whether a Foley catheter or a newly designed catheter was placed into the heart through cardiac lacerations. Changes in systolic blood pressures, mortality, and problems encountered during surgery and other intraoperative findings were recorded. RESULTS: There were higher mean blood pressure measurements in the newly designed catheter group during stages IV to VII. All subjects had tamponade and cardiac activity after completion of the repair of all lacerations in the catheter group, whereas in the other group only one subject did. Intraoperative direct fluid infusion to the heart through the catheters in the diastole was performed in all subjects of both groups. However, regurgitation from the cardiac cavity in the systole was seen only in the Foley catheter group. All of the intraoperative complications were seen in the same group.

Evaluation of oxidative stress parameters and metabolic activities of nurses working day and night shifts.

The aim of this study was to evaluate the oxidative stress and metabolic activities of nurses working day and night shifts. Intensive care unit (ICU) (n=70) and ordinary service (OS) nurses (n=70) were enrolled in the study. Just before and the end of the shifts, blood samples were obtained to measure the participants' oxidative stress parameters. Metabolic activities were analyzed using the SenseWear Armband. Oxidative stress parameters were increased at the end of the shifts for all OS and ICU nurses compared to the beginning of the shifts. Compared to the OS nurses, the ICU nurses' TAS, TOS, and OSI levels were not significantly different at the end of the day and night shifts. The metabolic activities of the OS and ICU nurses were found to be similar. As a result, the OS and ICU nurses' oxidative stress parameters and metabolic activities were not different, and all of the nurses experienced similar effects from both the day and night shifts.

Co-occurrence of diaphragmatic and serratus anterior muscle hydatidosis: an unusual localization.

BACKGROUND: With hydatid cyst, the skeletal muscles and diaphragm are rarely affected, and hepatic and pulmonary hydatid cysts are far more common. We report a case with an unusual localization of diaphragmatic and serratus muscle anterior hydatidosis that occurred simultaneously. CASE REPORT: A 37-year-old developmentally disabled woman presented to the Emergency Department (ED) of Harran University with tachycardia, tachypnea, and dyspnea. On pulmonary auscultation, breath sounds were decreased on the right side. A chest X-ray study revealed a radiopaque right hemithorax with a mediastinal shift and tracheal displacement. Thoracic computed tomography scan revealed a hydatid cyst in the serratus muscle anterior and cystic vesicles in the pleural cavity. The patient underwent chest drainage. During drainage, daughter vesicles within the pus were detected macroscopically. An elective thoracotomy was performed after hemodynamic stabilization of the patient. Postoperative chest X-ray study demonstrated that the lungs had re-expanded. The patient had no postoperative complications and was discharged with relief of all symptoms. CONCLUSION: Hydatid cyst should be considered, especially in endemic regions, in the differential diagnosis in the presence of a rare localization or unexpected clinical presentation. Surgical intervention is the appropriate approach for the treatment of hydatid cyst when there is concomitant intrathoracic involvement.

Pulmonary hypoplasia in a 52-year-old woman.

Pulmonary hypoplasia is a bronchopulmonary foregut anomaly characterized by a decreased number of alveoli and decreased alveolar air space. At autopsy, pulmonary hypoplasia is one of the important causes of death in newborns and infants. Pulmonary hypoplasia is rare in adults. In this paper, we present a case of pulmonary hypoplasia in a 52-year-old, asymptomatic woman. We discuss pulmonary hypoplasia and review the literature findings.

Extraskeletal Ewing sarcoma of the diaphragm presenting with hemothorax.

Ewing sarcoma is a relatively uncommon malignant bone neoplasm that usually occurs in children and young adults and involves the major long bones, pelvis, and ribs. Primary diaphragmatic Ewing sarcoma is extremely rare. To the best of our knowledge, only three cases of primary Ewing sarcoma of the diaphragm have been reported. A 12-year-old girl presented spontaneous occurrences of the right hemothorax. After drainage, a roentgenogram film, computed tomography, ultrasonography, and magnetic resonance image showed a giant mass on the right diaphragm. Primary diaphragmatic tumor was resected totally by right posterolateral thoracotomy, and histologically, an extraskeletal Ewing sarcoma was identified. The patient received adjuvant radio-chemotherapy, and there was no evidence of disease 10 months after the operation. Although extremely rare, extraskeletal Ewing sarcoma should be kept in mind in the differential diagnosis of diaphragmatic soft tissue tumors.

Solitary eosinophilic granuloma of sternum.

Primary bone tumors of the chest wall are uncommon, although a wide variety of both benign and malignant tumors arise within the chest wall. Among those tumors, sternal tumors are rare and usually malignant. We report an extremely rare case of eosinophilic granuloma developed in the sternum in a 30-year-old woman. She presented anterior chest pain and somewhat tender mass over the sternum. Chest roentgenogram, computed tomography scanning of the thorax, and total body bone scintigraphy revealed an isolated lytic lesion in the corpus sterni. A tru-cut biopsy of the mass exhibited the typical histologic appearance of eosinophilic granuloma. The solitary lesion was removed completely surgically. This rare condition should be kept in mind in differential diagnosis of sternal lesions.

Tracheobronchial foreign bodies: a 10 year experience.

BACKGROUND: Our aim is to describe foreign body aspiration in the tracheobronchial tree, a common emergency with serious consequences. METHODS: We reviewed the records of 357 patients who were admitted to our hospital during a 10-year period for the treatment of aspirated foreign body into the tracheobronchial tree. RESULTS: Of these cases, 42.4% were male and 57.6% female. Their ages ranged from 4 months to 70 years (average of 10.8 years). The most common manifestation was coughing, with subsequent dyspnea and wheezing. All underwent rigid bronchoscopy for the removal of the foreign body. Foreign bodies were localized in the right bronchial tree in 188 cases (52.7%), the left in 107 cases (30%) and trachea in 39 cases (10.9%). Foreign bodies were not found during bronchoscopy in 23 cases (6.4%). The foreign bodies were: needles (n=125), peanuts (n=110), plastic objects (n=52), and miscellaneous (n=47). Foreign bodies were removed by bronchoscopy in all but six cases (1.7%), who underwent limited thoracotomy. The present series had a mortality of 0.56 percent (two deaths) following removal of foreign body. CONCLUSIONS: Foreign body aspiration are rapidly recognized from the patient's history and easily treated by bronchoscopy and extraction of the aspirated foreign body. A high index of suspicion is crucial for early diagnosis. However, education is the best preventive measure for decreasing the incidence of this matter.

[Chest trauma: analysis of 592 cases]. / Toraks Travmalari: 592 Olgunun Analizi.

INTRODUCTION: Thoracic traumas constitute an important part of the patients who are being admitted to the emergency units and deaths due to trauma. The aim of this study was to compare our clinical experience and results of the literature. METHODS: 592 patients with thoracic trauma who were admitted to our clinic between 1996 and 2000 were evaluated retrospectively. RESULTS: 449 patients (75.8%) had blunt and 43 patients (24.2%) had penetrating thorax trauma. There was rib fracture in 448 patients (75.7%), clavicula fracture in 55 (9.2%), scapula fracture in 31 (5.2%) and sternal fracture in 20 (3.4%). In addition, flail chest was detected in 79 cases (13.3%). The most frequent complications were pneumothorax (n: 158; 26.7%), and hemothorax ( n: 119; 20.1% ). Three hundred and thirty - nine patients (57.2%) were treated by tube thoracostomy and 190 by conservative management (32.1%). Surgical treatment was performed in 99 (16.7%) patients. Morbidity was 18.4% ( n: 109 ) and mortality, 6.4% ( n: 38 ). Mean hospital stay time was 13.4 days (2 - 93 days). CONCLUSION: Thoracic traumas can cause vital organ injuries and impaired cardio-respiratory hemodynamics should be treated immediately.

Diagnosis and surgical treatment of Morgagni hernia: report of three cases.

Morgagni hernia is a rare congenital disorder, which is usually asymptomatic, but may cause respiratory or gastrointestinal symptoms. We reviewed the clinical findings of three patients with a Morgagni hernia, diagnosed and treated in our department between 1997 and 2000. The Morgagni hernia caused various symptoms in all three patients and surgery was performed via posterolateral thoracotomy in two, and via laparatomy in one. The hernial defect was closed by primary suturing in two patients and by synthetic mesh in one. All three patients had an uneventful postoperative recovery. We believe that the transthoracic approach is an effective way of repairing Morgagni hernia.

Complications of albendazole treatment in hydatid disease of lung.

We present rupture of lung hydatid cyst in a patient with multiple organ involvement during albendazole treatment. The patient was first provided mechanical ventilation than residue cavity and the other intact cyst was treated surgically. We concluded that albendazole should be used in postoperative period in patients with hydatid disease of the lung to prevent recurrent disease.

Tension pneumothorax associated with hydatid cyst rupture.

SUMMARY: Hydatid disease is common in Turkey. Tension pneumothorax is rare, but it is an important complication of the hydatid cyst with significant morbidity and mortality. Tension hydropneumothorax secondary to the rupture of a hydatid cyst was detected in 5 of 185 spontaneous pneumothorax cases that were treated in the authors' clinic between 1992 and 1998. All patients were subjected to surgical treatment after urgent tube thoracostomy. No mortality or recurrence was observed at follow-ups of 9 to 24 months.