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SUMMARY OBJECTIVE: Pulmonary metastasectomy for the treatment of metastatic colorectal cancer is essential, but high ranked evidence of survival benefit is lacking. Here, we aimed to examine the prognostic factors after pulmonary metastasectomy in patients with colorectal cancer. METHODS: This is a single-center, retrospective hospital-based observational case series study. We reviewed data for 607 patients with metastatic colorectal cancer (mCRC) who were treated and observed from 2012 to 2019. Of the 607 patients with mCRC, 87 were with solitary lung metastases. Of the 87 patients, 39 were not appropriate for metastasectomy, while 15 patients recognized as suitable candidates by the multidisciplinary thoracic tumor board rejected metastasectomy. Consequently, only 33 patients were included in the final analysis. RESULTS: Rectum was detected as the primary site in 16 (48.5%) patients. Over 80% of patients had metachronous lung metastases, with a median of 29.0 months from initial diagnosis. Video-assisted thoracic surgery with wedge resection was performed in 20 (60.6%) patients. Over 90% of patients had solitary metastasis resected, with 97% of R0 resection. Median tumor size was 23.0 mm (min: 10; max: 90). Adjuvant treatment was given to 31 (93.9%) patients, while neoadjuvant treatment was given only to 8 (25%) patients. Of the 33 patients, there were 25 (75.7%) relapses. The most frequent site of relapse was lung in 15 (45.5%) patients. Interestingly, there were only 4 (12.2%) patients who had a relapse in the liver after lung metastasectomy. We found that median disease-free survival (DFS) and overall survival (OS) were 43.0 (13.0–73.0) and 55.0 (31.6–78.4) months, respectively. CONCLUSIONS: Pulmonary metastasectomy was associated with significantly long-time survival rates in mCRC (43 months of DFS and 55 months of OS). The second relapse occurred in 25 (75.7%) patients, with isolated lung metastases in nearly half of the patients (45.5%). Therefore, lung metastases in mCRC were unique and a multidisciplinary team including a thoracic surgeon should manage these patients.

Rheumatoid arthritis (RA) is a systemic disease with symmetrical, polyarticular joint involvement. In patients with RA, pleural effusion usually occurs a few years after the onset of the disease and is often considered as a disease exacerbation. RA may cause pleural effusion, interstitial lung disease, pleuritis, airway disease and rheumatoid nodule in the lungs. Aseptic exudative pleural effusions with low pH, low glucose and high lactate dehydrogenase (LDH) values might be seen in RA. Diagnosis is usually made by exclusion of other pleural fluid causes. In this study, a 52-year-old patient who was diagnosed as RA 6 months ago and treated irregularly was presented to emphasize that pleural effusion may develop in patients with irregular RA. The patient had previously undiagnosed chronic obstructive pulmonary disease (COPD) and the patient’s COPD treatment was also regulated. It should not be forgotten that pleural effusion may develop among RA patients with irregular treatment., Romatoid artrit (RA) simetrik, poliartiküler eklem tutulumu olan sistemik bir hastalıktır. RA’lı hastalarda plevral efüzyon genellikle hastalık başladıktan bir kaç yıl sonra ortaya çıkar ve sıklıkla hastalık alevlenmesi olarak kabul edilir. RA akciğer tutulumu olarak; plevral efüzyon, plörit, hava yolu hastalığı, romatoid nodül ve intertisyel akciğer hastalığı görülür. Plevral sıvı aseptik eksuda karakterindedir ve sıvıda düşük pH, düşük glukoz ve yüksek laktat dehidrogenaz (LDH) değerleri görülür. Tanı genellikle diğer plevral sıvı nedenlerinin dışlanması sonucu konulur. Bu çalışmada, 6 ay önce RA tanısı konan ve düzensiz tedavi alan 52 yaşındaki hasta, düzensiz RA tedavisi alan hastalarda plevral sıvı gelişebileceğini vurgulamak amacıyla sunulmuştur. Hastada daha önce tanı konulmamış kronik obstruktif akciğer hastalığı (KOAH) mevcuttu ve hastanın KOAH tedavisi de düzenlendi. Düzensiz RA tedavisi alan olgularda RA’ya bağlı olarak plevral efüzyon gelişebileceği unutulmamalıdır.

Kültürel bir varoluş olarak delilik, kendisine çeşitli anlamlar atfedilerek, tarih boyunca toplumsal kabullerde ve dolayısıyla sanat dallarında sıkça karşımıza çıkar. Delilik, toplumun istenmeyen bir parçası olmakla beraber; toplumun içinde ve toplumdan başka olan bir varoluşa da sahiptir. Bu nedenle, deli ne boyutla ele alınırsa alınsın; her zaman normal olmayanı temsil eder. Oysa; Foucaultcu bakış açısı ile incelendiğinde delilik, içinde barındırdığı anlamlar bakımından tarih içinde gelişen güç ve iktidar paradigmalarını açığa çıkarabilecek bir olgudur. Bu çalışma, filmlerdeki delilik olgusunu tartışarak günümüz toplumlarında kabul görmüş delilik hallerini ve modern hayatın iktidar uygulamaları ile delilik arasındaki ilişkiyi incelemektedir. Delilik sanıldığının aksine sadece pozitif tıbbın temellerine dayanan bir psikolojik bozukluk değil; aynı zamanda modern toplumun kuruluşunda iktidar mekanizmalarının güç uygulama pratiklerini kolaylaştırmak için normal olanın inşasında kullanılmış bir yapıdır.

Background: This study aims to determine a new cut-off value for standardized uptake value in positron emission tomography-computed tomography evaluation of mediastinal lymph nodes in non-small cell lung cancer in Turkey.

Intrathoracic gossypiboma, a retained surgical sponge in the thoracic cavity, is a rare but serious complication of thoracic surgeries. A 70-year-old man presented with an eight-month history of cough. He had undergone coronary artery bypass surgery eight years ago. The posteroanterior chest X-ray revealed a well-marginated homogeneous opacity at the left hemithorax with striped appearance in the center. Thoracic CT revealed a pleural-based mass at the left lower lobe with a hyperdense rim. After the diagnosis of gossypiboma, it was removed surgically. Although rare after thoracic surgery, gossypibomas need to be considered in the differential diagnosis in case of respiratory symptoms.