Papers by Songül Büyükkale
Turkish Journal of Thoracic and Cardiovascular Surgery
Background: In this study, we aimed to compare the performances of clinical methods, minimally in... more Background: In this study, we aimed to compare the performances of clinical methods, minimally invasive methods, mediastinoscopy, and re-mediastinoscopy used in the restaging of patients receiving neoadjuvant therapy for pathologically proven N2. Our secondary objective was to determine the most optimal algorithm for initial staging and restaging after neoadjuvant therapy. Methods: Between April 2003 and August 2017, a total of 105 patients (99 males, 6 females; mean age: 54.5±8.2 years; range, 27 to 73 years) who were diagnosed with pathologically proven Stage 3A-B N2 non-small cell lung cancer and received neoadjuvant therapy and subsequently lung resection were retrospectively analyzed. Staging algorithm groups (Group 1=first mediastinoscopy-second clinic, Group 2=first mediastinoscopy-second minimally invasive, Group 3=first mediastinoscopy-second re-mediastinoscopy, and Group 4=first minimally invasive-second mediastinoscopy) were created and compared. Results: In the first sta...
Thoracic Cancer, 2013
Background: Extended cervical mediastinoscopy (ECM) is a method used for staging non-small cell l... more Background: Extended cervical mediastinoscopy (ECM) is a method used for staging non-small cell lung cancer (NSCLC). Methods: Between 1998 and 2011, 159 patients underwent ECM who had left NSCLC, were retrospectively analyzed. If the cN2 was limited to the paratracheal or subcarinal spaces without infiltrating the paraortic or subaortic spaces, these cases excluded from the study (negative cases of ECM and positive cases of SCM). Patients who had been reported as cN0 by mediastinoscopy underwent thoracotomy for tumor resection. Results: Localization of the tumor was upper lobe in 81 patients (50.9%), central in 56 patients (35.3%), lower lobe in 22 patients (13.8%). ECM was successful at harvesting one or more aortopulmonary (APW) lymph nodes in 153 patients (96.2%) (#5 and #6 sampling in 82 patients, #5 or #6 sampling in 71 patients). Mediastinal lymph node metastasis was observed in 36 patients (22.6%) via mediastinoscopy. APW lymph node metastases were shown in 26 of these patients (true-positive of ECM), remaining 10 patients who had mediastinal lymph nodes metastasis that could be accessed only via SCM were exclueded. 123 patients who identified as cN0 by mediastinoscopy were operated; 64 lobectomies, 43 pneumonectomies, 16 exploratory thoracotomies. The pathological examination of the mediastinal lymphadenectomies revealed APW lymph node metastases in 11 patients (false-negative of ECM). Sensitivity, NPV and accuracy of ECM were calculated as 0.70, 0.91, and 0.92, respectively. Conclusions: ECM has an adequate NPV and accuracy in determining metastases to the APW lymph nodes in patients with left NSCLC
The Turkish Journal of Thoracic and Cardiovascular Surgery, 2017
Bu çalışmada akciğer nakli merkezimizin erken dönem akciğer nakli sonuçları sunuldu.
European Respiratory Journal, 2015
Background and aim: Malignant Mesothelioma is aggressive pleural tumors. We need an easily access... more Background and aim: Malignant Mesothelioma is aggressive pleural tumors. We need an easily accessible, inexpensive and reliable method for determining low survival time prognosis of this tumor. The aim of our study investigate neutrophil / lymphocyte ratio and platelet / lymphocyte ratio as a prognostic indicator of the availability. Materials and methods: Thirty six malignant mesothelioma patients, whose histopathologic diagnosis was established and followed by our clinic, accesible to complete archive data were included. Our study is designed as a retrospective. Patients9 histopathological types, disease stages, a complete blood count parameters at diagnosis and survival were recorded. Results: Eighteen of Malignant mesothelioma patients were male and average follow-up period was 24.83 ± 3.61 months. PLR levels of patients according to mortality varies statistically significant (p<0.05). The area under the ROC curve for the NLR is 0.559 and the p-value for the NLR is 0.631. The area under the ROC curve for the PLR is 0,749 and the p-value for the PLR is 0,044 . Conclusion: PLR is significantly prognostic indicator of malignant mesothelioma at diagnosis on complete blood count parameters, however there is no significant prognostic indicator on NLR. A large number of prospective studies are needed to prove the reliability of the parameters.
Eurasian Journal of Pulmonology, 2015
for foreign body aspiration and whom foreign body was sentential by intervention were included. D... more for foreign body aspiration and whom foreign body was sentential by intervention were included. Data were used from a retrospective analysis. Results: From the 28 patients, 64.3% of them were women and mean age of the patients were 43.5±21.54 years. Most common presenting symptom was cough (96.3%). Half of the patients were presented in 24 hours after the procedure. From the 5 patients that have undergone diagnostic broncoscopy by fiberoptic bronchoscope, foreign body was removed in 3 of them. Rigid bronchoscopy was done in 25 (89.3%) of the patients. In 3 of the patients foreign body cannot be detected by bronchoscopy and removed by surgery. 67.9% of the foreign bodies that were removed were inorganic in nature. Conclusion: Bronchoscopic approaches are effective to decrease mortality and morbidity for the diagnosis and treatment of foreign body aspirations in adults. Rigid bronchoscopic approach should be the first choice in foreign body aspirations but fiberoptic bronchoscopy can also be used in selective cases by experienced physicians.
Interactive Cardiovascular and Thoracic Surgery
Turkish Journal of Thoracic and Cardiovascular Surgery, 2013
Bu çalışmada karinal invazyon nedeni ile karinal rezeksiyon ve rekonstrüksiyon uyguladığımız mali... more Bu çalışmada karinal invazyon nedeni ile karinal rezeksiyon ve rekonstrüksiyon uyguladığımız malign tümörlü hastaların klinik sonuçları incelendi. Ça lış mapla nı:Ocak 2002-Mayıs 2011 tarihleri arasında karinal invazyon nedeni ile karinal rezeksiyon ve rekonstrüksiyon uygulanan malign tümörlü 19 hasta (18 erkek, 1 kadın; ort. yaş 54.8±10.0 yıl; dağılım 29-73 yıl) ameliyat tekniği, komplikasyon, ameliyat endikasyonları ve uzun dönem takipleri açısından incelendi. Trakea ve bronş rezeksiyonu sonrası, sol ana bronş, ameliyat sahasına alınan steril spiralli entübasyon tüpü ile entübe edildi. Bul gu lar: İkisi ikinci primer olmak üzere, 14 hastada küçük hücreli dışı akciğer karsinomu (KHDAK), üç hastada adenoid kistik karsinom vardı. On hastaya karinal sleeve pnömonektomi (ikisi tamamlayıcı olmak üzere), sekiz hastaya lobektomi ile kombine karina rezeksiyonu ve rekonstrüksiyonu ve bir hastaya izole karina rezeksiyonu ve rekonstrüksiyonu sağ posterolateral torakotomi ile uygulandı. Adenoid kistik karsinom nedeni ile ameliyat edilen iki hasta dışında tüm hastalarda komplet rezeksiyon yapıldı (komplet rezeksiyon oranı: %89.4). Cerrahi mortalite ve morbidite oranı sırası ile %10.5 (n=2) ve %26.3 (n=5) idi. Mortalite oranı açısından rezeksiyon tipleri arasında fark yok iken, karinal sleeve pnömonektomi uygulanan hastalarda, diğer hastalara kıyasla, daha fazla komplikasyon (%40'a kıyasla %11.1) geliştiği saptandı. Ortalama 45.4±37.6 ay (medyan 34 ay) takip edilen hastaların üç yıllık sağkalımı %72.9 idi. So nuç: Karinal rezeksiyon ve rekonstrüksiyon, seçilmiş hastalarda kabul edilebilir mortalite, morbidite ve iyi uzun dönem takip sonuçları ile güvenle uygulanabilir. Anah tar söz cük ler: Karinal invazyon; rekonstrüksiyon; sleeve karinal rezeksiyon; cerrahi. Background:This study aims to analyze the clinical outcomes of patients with malignant tumors after carinal resection and reconstruction due to carinal invasion. Methods: Between January 2002 and May 2011, 19 patients (18 males, 1 female; mean age 54.8±10.0 years; range 29 to 73 years) who underwent carinal resection and reconstruction due to carinal invasion were analyzed for operative technique, complications, operation indications and long-term follow-up. After resection of the trachea and bronchus, the left main bronchus is intubated across the operative field with a sterile spiral tube. Results: Fourteen patients had non-small cell lung carcinoma (NSCLC), while three patients had adenoid cystic carcinoma including two with second primary carcinoma. The resections were as carinal sleeve pneumonectomy for 10 patients (two of them complementary pneumonectomy), lobectomy combined with carinal resection and reconstruction for eight patients, and isolated carinal resection and reconstruction through right posterolateral thoracotomy for one patient. A complete resection was performed in all patients except two undergoing surgery due to adenoid cystic carcinoma (complete resection rate: 89.4%). Surgical mortality and morbidity rates were 10.5% (n=2) and 26.3% (n=5), respectively. The mortality rate was indifferent between the resection types; however, patients undergoing carinal sleeve pneumonectomy had frequent complications, compared to the other patients (11.1% versus 40%). Three-year survival was 72.9% in patients with a mean follow-up of 45.4±37.6 months (median 34 months). Conclusion: The carinal resection and reconstruction can be safely used in selected patients with an acceptable mortality, morbidity and good long-term follow-up outcomes.
Turkish Journal of Thoracic and Cardiovascular Surgery, 2015
ÖZ Amaç: Bu çalışmada akciğer karsinoidleri olan hastaların uzun süreli takiplerinde lenf nodu in... more ÖZ Amaç: Bu çalışmada akciğer karsinoidleri olan hastaların uzun süreli takiplerinde lenf nodu invazyonu ve hücre tipi dışında sağkalımı etkileyebilecek olası faktörler incelendi. Ça lış ma pla nı: Bu retrospektif çalışmaya Şubat 1993 -Kasım 2012 tarihleri arasında bronşiyal karsinoid tanısı ile ameliyat edilen 82 hasta (36 erkek, 46 kadın; ort. yaş 43.8 yıl; dağılım 16-19 yıl) dahil edildi. Sağkalımı etkileyebilecek faktörler yaş, cinsiyet, cerrahinin yeri, T statüsü, N statüsü, tam rezeksiyon, rezeksiyon genişliği, hücre tipi ve evre olarak belirlendi. Morbidite ve mortaliteler bu faktörlere göre kaydedildi. Bul gu lar: Ortalama takip süresi 84 ay idi. On yıllık sağkalım oranı %98.5 idi. Hastalardan 49'u T 1 , 29'u T 2 , dördü T 3 idi. Veriler T statüsünün sağkalımı etkilediğini gösterdi (p= 0.001). Yedinci TNM evreleme sistemine göre, hastaların 65'i evre 1, 14'ü evre 2, ikisi evre 3 idi. Bir hastada cerrahi sınırlar pozitif idi. Hastalık evresinin sağkalım üzerinde etkisi var idi (p= 0.023). Altmış sekiz hastada tipik, 14 hastada atipik karsinoid var idi. Tipik ve atipik karsinoidlerde sağkalımda farklılık yok idi (p= 0.62). Yetmiş hasta N 0 , 10 hasta N 1 ve iki hasta N 2 idi. Verilere göre, N durumu sağkalımı etkilemedi (p=0.72). So nuç: Çalışmamızda erken evrede tespit edilen tümörlere uygulanan cerrahide prognozun daha iyi olduğu bulundu. Anah tarsöz cük ler: Mortalite; pulmoner karsinoid tümör; sağkalım.
Viruses , 2020
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a member of the betacoronavirus f... more Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a member of the betacoronavirus family, which causes COVID-19 disease. SARS-CoV-2 pathogenicity in humans leads to increased mortality rates due to alterations of significant pathways, including some resulting in exacerbated inflammatory responses linked to the "cytokine storm" and extensive lung pathology, as well as being linked to a number of comorbidities. Our current study compared five SARS-CoV-2 sequences from different geographical regions to those from SARS, MERS and two cold viruses, OC43 and 229E, to identify the presence of miR-like sequences. We identified seven key miRs, which highlight considerable differences between the SARS-CoV-2 sequences, compared with the other viruses. The level of conservation between the five SARS-CoV-2 sequences was identical but poor compared with the other sequences, with SARS showing the highest degree of conservation. This decrease in similarity could result in reduced levels of transcriptional control, as well as a change in the physiological effect of the virus and associated host-pathogen responses. MERS and the milder symptom viruses showed greater differences and even significant sequence gaps. This divergence away from the SARS-CoV-2 sequences broadly mirrors the phylogenetic relationships obtained from the whole-genome alignments. Therefore, patterns of mutation, occurring during sequence divergence from the longer established human viruses to the more recent ones, may have led to the emergence of sequence motifs that can be related directly to the pathogenicity of SARS-CoV-2. Importantly, we identified 7 key-microRNAs (miRs 8066, 5197, 3611, 3934-3p, 1307-3p, 3691-3p, 1468-5p) with significant links to KEGG pathways linked to viral pathogenicity and host responses. According to Bioproject data (PRJNA615032), SARS-CoV-2 mediated transcriptomic alterations were similar to the target pathways of the selected 7 miRs identified in our study. This mechanism could have considerable significance in determining the symptom spectrum of future potential pandemics. KEGG pathway analysis revealed a number of critical pathways linked to the seven identified miRs that may provide insight into the interplay between the virus and comorbidities.
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Papers by Songül Büyükkale