IntroductionPulmonary aspergilloma is the most common human disease caused by saprophytic species of the genus Aspergillus (1,2). It involves the formation of a fungus ball or mycetoma. Antifungal agents are usually ineffective and a cure can be achieved only with surgical treatment (1,3,4). Patients with an aspergilloma require surgical treatment because there is a risk of sudden life-threatening hemoptysis, and alternative medical treatments are usually ineffective. However, the surgical indications remain controversial because of the high incidence of postoperative complications (1,5,6).This retrospective study analyzed the clinical presentation, underlying lung disease, surgical indications, techniques, treatment outcomes, and postoperative complications of pulmonary aspergilloma. Materials and methodsWe operated on 77 patients for pulmonary aspergilloma between January 2000 and December 2013. The medical records were reviewed to determine the patients' history, clinical presentation, underlying lung disease, indications for surgery, surgical procedures, and postoperative complications. The subjects included 53 males (mean age: 44.26 (range: 10-73) years) and 24 females (mean age: 48.25 (range: 26-70) years).The patients were diagnosed based on history and radiological findings on a posteroanterior lung X-ray or computed tomography. We classified the lesions as simple pulmonary aspergilloma (SPA) if the lesion was welllocalized, with a thin-walled cavity smaller than 5 cm and little or no surrounding atelectasis or consolidated areas. Lesions were classified as complex pulmonary aspergilloma (CPA) if they were well-localized, thin-walled cavities larger than 5 cm or with thick walls, and surrounded by parenchymal sequelae as disseminated consolidation and atelectasis resulting from underlying lung disease, such as bronchiectasis or tuberculosis in most cases (Figure 1) (7-11).Background/aim: This retrospective study evaluated the clinical presentation, underlying lung disease, surgical indications, technique, treatment outcomes, and postoperative complications of pulmonary aspergilloma. Materials and methods:We evaluated 77 patients who underwent pulmonary resection of an aspergilloma at Atatürk Chest Diseases and Thoracic Surgery Research and Training Hospital between January 2000 and December 2013. The initial operations were 4 pneumonectomies, 24 lobectomies, 9 lobectomy plus myoplasties, 10 segmental resections, and 30 wedge resections. Six reoperations were carried out to deal with postoperative complications: 1 myoplasty, 2 completion lobectomies plus myoplasties, 2 myoplasties with rib resections, and 1 completion lobectomy. Results:The subjects comprised 53 males (mean age: 44.26 (range: 10-73) years) and 24 females (mean age: 48.25 (range: 26-70) years). The most common indication for surgery was hemoptysis in 52 patients (67.53%). The most common underlying lung disease was tuberculosis in 37 patients (48.05%). Forty patients (51.94%) had a simple pulmonary aspergilloma and 37 (48.05%) had a complex...

Management of tracheal complications due to endotracheal intubation in patients with coronavirus disease-2019 (COVID-19) is an important concern. This study aimed to present the  results of patients who had undergone tracheal resection and reconstruction due to COVID-19-related complex post-intubation tracheal stenosis (PITS). We evaluated 15 patients who underwent tracheal resection and reconstruction due to complex PITS between March 2020 and April 2021 in a single center. Seven patients (46.6%) who underwent endotracheal intubation due to the COVID-19 constituted the COVID-19 group, and the remaining 8 patients (53.4%) constituted the non-COVID-19 group. We analyzed the patients’ presenting symptoms, time to onset of symptoms, radiological and bronchoscopic features of stenosis, bronchoscopic intervention history, length of the resected tracheal segment, postoperative complications, length of hospital stay, and duration of follow-up. Six of the patients (40%) were female, and 9 (60%) were male. Mean age was 43.3 ± 20.5. We found no statistically significant difference between the COVID-19 and non-COVID-19 PITS groups in terms of presenting symptoms, time to onset of symptoms, stenosis location, stenosis severity, length of the stenotic segment, number of bronchoscopic dilatation sessions, dilatation time intervals, length of the resected tracheal segment, postoperative complications, and length of postoperative hospital stay. Endotracheal intubation duration was longer in the COVID-19 group than non-COVID-19 group (mean ± SD: 21.0 ± 4.04, 12.0 ± 1.15 days, respectively). Tracheal resection and reconstruction can be performed safely and successfully in COVID-19 patients with complex PITS. Comprehensive preoperative examination, appropriate selection of surgery technique, and close postoperative follow-up have favorable results.

For the public welfare and safety, buildings such as hospitals, industrial facilities, and technology centers need to remain functional at all times; even during and after major earthquakes. The values of these buildings themselves may be insignificant when compared to the cost of loss of operations and business continuity. Seismic isolation aims to protect both the integrity and the contents of a structure. Since the tolerable acceleration levels are relatively low for continued services of vibration-sensitive high-tech contents, a better understanding of acceleration response behaviors of seismically isolated buildings is necessary. In an effort to shed light to this issue, following are investigated via bi-directional time history analyses of seismically isolated benchmark buildings subject to historical earthquakes: (i) the distribution of peak floor accelerations of seismically isolated buildings subject to seismic excitations in order to find out which floors are likely to sustain the largest accelerations; (ii) the influence of equivalent linear modeling of isolation systems on the floor accelerations in order to find out the range of possible errors introduced by this type of modeling; (iii) the role of superstructure damping in reducing floor accelerations of seismically isolated buildings with flexible superstructures in order to find out whether increasing the superstructure damping helps reducing floor accelerations notably. Influences of isolation system characteristics and superstructure flexibility are both taken into account.

Background Coronavirus disease 2019 (COVID‐19) is a global health problem. However, the course of this disease in immunosuppressed patients remains unknown. This study aimed to describe the course of COVID‐19 infection and its effects on lung transplant recipients. Methods This was a single‐center, retrospective, observational study. The recipients with suspicious symptoms and/or a contact history with infected individuals were diagnosed with COVID‐19 by performing a reverse transcription‐polymerase chain reaction (RT‐PCR) test using samples obtained from the nasopharynx swabs or bronchial lavage. We classified the patients into mild, moderate, and high severity groups according to their clinical conditions. In patients with positive RT‐PCR results, cell cycle inhibitor drugs were withdrawn, while steroids were maintained at the same level as in patients without clinical deterioration. Results Of the seven recipients diagnosed with COVID‐19 infection, one experienced a re‐infection. Each recipient had at least one comorbidity. Smell disorder (12.5%), cough/dyspnea (37%), and fever/chills/shivering (37%) were the most frequent symptoms. The mean follow‐up time after infection was 108 days. No deaths were recorded due to COVID‐19; however, the pulmonary function test values of two recipients were decreased during subsequent follow‐ups. Conclusion In our small group of transplant recipients with COVID‐19, there were two cases of pulmonary function deterioration and a case of re‐infection, and no recipient died. It is suggested that steroid therapy should be initiated in the early period in patients with pulmonary opacities.