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2.
Turk Gogus Kalp Damar Cerrahisi Derg ; 28(1): 188-196, 2020 Jan.
Article in English | MEDLINE | ID: mdl-32175161

ABSTRACT

BACKGROUND: This study aims to evaluate gene expression levels in the diagnosis of lung adenocarcinoma and malignant pleural mesothelioma both which have a distinct treatment and prognosis. METHODS: Between January 2012 and January 2014, 12 newly diagnosed patients with a lung adenocarcinoma, 12 patients with malignant pleural mesothelioma, and eight healthy individuals as the control group were included. After treatment of the fresh samples of lung adenocarcinoma stored at -80°C for ribonucleic acid isolation, and paraffin-embedded tissues of patients with malignant pleural mesothelioma were deparaffinized, complementary deoxyribonucleic acid synthesis and expression of 84 genes associated with deoxyribonucleic acid repair were analyzed via real-time polymerase chain reaction assay. According to the expression of tumor cells, expression of each fold change was calculated. RESULTS: The BRCA1, BRCA2, CDK7, MLH3, MSH4, NEIL3, SMUG1, UNG, XRCC2, and XRCC4 genes showed more than five-fold higher expression in the patients with lung adenocarcinomas, compared to the control group. The patients with malignant pleural mesothelioma showed a five-fold higher expression in the APEX2, BRCA1, BRCA2, CDK7, MLH1, MLH3, MSH3, MSH4, NEIL3, PARP2, PARP3, PMS1, RAD50, RAD51, RAD51B, RAD51D, RAD52, RPA3, SMUG1, UNG, XPA, XRCC2, and XRCC4 genes, compared to the control group. Comparing malignant pleural mesothelioma with lung adenocarcinoma cases, we found that CDK7, MLH1, TREX1, PRKDC, XPA, PMS1, UNG, and RPA3 genes were overexpressed. CONCLUSION: Our study results showed differences between expression profiles of deoxyribonucleic acid repair genes in lung adenocarcinoma and malignant pleural mesothelioma cells. Based on our study results, we suggest that TREX1, PRKDC, and PMS1 genes may play a key role in the differential diagnosis of these two entities.

3.
Respir Care ; 64(2): 189-195, 2019 Feb.
Article in English | MEDLINE | ID: mdl-30401755

ABSTRACT

BACKGROUND: Activities of daily living (ADL) are important for an independent life. As COPD progresses, the ability to complete ADL is usually reduced. Knowing the possible factors that influence the ability to perform ADL may allow better targeting of appropriate rehabilitation programs to increase the independence levels and/or to prevent further decreases in patients with COPD. Therefore, the aim of this study was to investigate ADL performance as measured by the London Chest Activity of Daily Living scale, which is a commonly used measure in patients with COPD. METHODS: This cross-sectional study included 44 clinically stable subjects who were not taking antibiotics and had not made any changes in their medications for at least three weeks with a COPD diagnosis based on Global Initiative for Chronic Obstructive Lung Disease. Demographic characteristics, pulmonary function, ADL measured by the London Chest Activity of Daily Living scale, functional exercise capacity via the 6-min walk distance, disease-related symptoms measured by the COPD Assessment Test, and peripheral and respiratory muscle strength were evaluated. A multiple linear regression (stepwise) analysis was used to determine the variables that have the greatest influence on ADL (ie, the London Chest Activity of Daily Living scale score). RESULTS: The London Chest Activity of Daily Living scale score had moderate correlations with the COPD Assessment Test score (r = 0.31, P = .041), maximum expiratory pressure value (r = -0.37, P = .01), 6-min walk distance (r = -0.48, P = .001), knee extensor muscle strength (r = -0.47, P = .001), handgrip strength (r = -0.44, P = .003). The 6-min walk distance, COPD Assessment Test score and maximal expiratory pressure values were significant and independent determinants of the London Chest Activity of Daily Living scale, with 40.1% of the variance in subjects with COPD. CONCLUSIONS: Functional exercise capacity, disease-related symptoms, and expiratory muscle strength have the greatest influence on ADL in the subjects with COPD. The level of independence to perform ADL can be increased by improving functional exercise capacity, reducing symptoms, and increasing expiratory muscle strength in subjects with COPD.


Subject(s)
Activities of Daily Living , Disability Evaluation , Pulmonary Disease, Chronic Obstructive/physiopathology , Severity of Illness Index , Aged , Cross-Sectional Studies , Exercise Test , Exercise Tolerance/physiology , Female , Forced Expiratory Volume , Hand Strength , Humans , Male , Middle Aged , Muscle Strength , Physical Functional Performance , Respiratory Muscles/physiopathology , Spirometry/statistics & numerical data , Walk Test
4.
Adv Clin Exp Med ; 26(2): 303-309, 2017.
Article in English | MEDLINE | ID: mdl-28791850

ABSTRACT

BACKGROUND: Pulmonary thromboembolism (PE) is a major disease in respiratory emergencies. Thoracic CT angiography (CTA) is an important method of visualizing PE. Because of the high radiation and contrast exposure, the method should be performed selectively in patients in whom PE is suspected. OBJECTIVES: The aim of the study was to identify the role of clinical scoring systems utilizing CTA results to diagnose PE. MATERIAL AND METHODS: The study investigated 196 patients referred to the hospital emergency service in whom PE was suspected and CTA performed. They were evaluated by empirical, Wells, Geneva and Miniati assessments and classified as low, intermediate and high clinical probability. They were also classified according to serum D-dimer levels. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated and evaluated according to CTA findings. RESULTS: Empirical scoring was found to have the highest sensitivity, while the Wells system had the highest specificity. When low D-dimer levels and "low probabilty" were evaluated together for each scoring system, the sensitivity was found to be 100% for all methods. Wells scoring with a cut-off score of 4 had the highest specificity (56.1%). CONCLUSIONS: Clinical scoring systems may be guides for patients in whom PE is suspected in the emergency department. The empirical and Wells scoring systems are effective methods for patient selection. Adding evaluation of D-dimer serum levels to the clinical scores could identify patients in whom CTA should be performed. Since CTA can only be used conservatively, the use of clinical scoring systems in conjunction with D-dimer levels can be a useful guide for patient selection.


Subject(s)
Algorithms , Angiography/methods , Pulmonary Embolism/diagnostic imaging , Pulmonary Embolism/diagnosis , Tomography, X-Ray Computed/methods , Aged , Aged, 80 and over , Emergency Service, Hospital/statistics & numerical data , Female , Fibrin Fibrinogen Degradation Products/analysis , Humans , Male , Middle Aged , Prospective Studies , Pulmonary Embolism/blood , Reproducibility of Results , Sensitivity and Specificity
5.
Medicine (Baltimore) ; 96(6): e5903, 2017 Feb.
Article in English | MEDLINE | ID: mdl-28178129

ABSTRACT

BACKGROUND: Lung cancer is responsible of 12.4% and 17.6% of all newly diagnosed cancer cases and mortality due to cancer, respectively, and 5-year survival rate despite all improved treatment options is 15%. This survival rate reaches 66% in the Stage 1 and surgically treated patients. Early diagnosis which could not be definitely and commonly achieved yet is extremely critical in obtaining high survival rate in this disease. For this reason; proteomic differences were evaluated using matrix assisted laser desorption ionization (MALDI) mass spectrometry in the subgroups of lung adenocarcinoma and squamous cell carcinoma. METHODS: Fresh tissue samples of 36 malignant cases involving 83.3% (n = 30) men and 16.7% (n = 6) women patients were distributed into 2 groups as early and end stage lung cancer and each group were composed of subgroups including 18 squamous cell carcinoma (9 early stage cases, 9 end stage cases) and 18 adenocarcinoma cases (9 early stage cases, 9 end stage cases). The fresh tissues obtained from the tumoral and matched normal sites after surgical intervention. The differences in protein expression levels were determined by comparing proteomic changes in each patient. RESULTS: In the subgroups of advanced stage adenocarcinoma; tumoral tissue revealed differences in expression of 2 proteins compared with normal parenchymal tissue. Of those; difference in protein expression in heat shock protein 60 (HSP60) was found statistically significant (P = 0.0001). Subgroups of early and advanced stage squamos cell carcinoma have differed in certain 20 protein expression of normal tissue and diseased squamos cell carcinoma. Of those, increased protein expression level of only annexin-2 protein was found statistically significant (P = 0.002). No significant difference was detected in early and advanced stage protein expressions of the tumoral tissues in the subgroups of adenocarcinoma and squamous cell carcinoma. CONCLUSIONS: We conclude that with respect to early diagnosis of lung cancer that HSP60 and annexin-2 proteins are the important biomarkers in the subgroups of adenocarcinoma and squamous cell carcinoma. We also consider that these 2 proteins are molecules which may provide critical contribution in evaluation of prognosis, metastatic potential, response to treatment, and in establishment of differential diagnosis between adenocarcinoma and squamous cell carcinoma.


Subject(s)
Annexin A2/metabolism , Biomarkers, Tumor/metabolism , Carcinoma, Non-Small-Cell Lung/metabolism , Chaperonin 60/metabolism , Lung Neoplasms/metabolism , Mitochondrial Proteins/metabolism , Aged , Carcinoma, Non-Small-Cell Lung/diagnosis , Early Diagnosis , Female , Humans , Lung Neoplasms/diagnosis , Male , Middle Aged , Proteome , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
6.
J Pak Med Assoc ; 65(6): 632-6, 2015 Jun.
Article in English | MEDLINE | ID: mdl-26060161

ABSTRACT

OBJECTIVE: To determine the effects of methyl palmitate on murine model of chronic asthma. METHODS: The experimental study was conducted in the animal laboratory of DokuzEylul University, Turkey, from October to December, 2012, and comprised BALB/c mice whowere divided into four equal groups: three experimental and one control group. All groups except the control group were sensitised and challenged with ovalbumin. Mice with experimentally-induced asthma in Group I received saline; Group II dexamethasone 1mg/kg; Group III methyl palmitate300mg/kg intraperitoneally three times per week in the last four weeks of the study period. Animals were sacrificed 24h after the last administration of study drugs. Histological findings of airways were evaluated by light microscopic examination. Blood samples from vena cava inferior were taken for measurement of interleukin-5 levels. SPSS 15 was used for statistical analysis. RESULTS: The 28 female mice in the study were divided into 4 groups of 7(25%) each. The age range of the animals was 6-8weeks, and the weight range was 18-20g. All histological parameters and interleukin-5 levels of asthma in the Group III were significantly ameliorated compared to the Group I (p<0.05). All histological parameters and interleukin-5 levels were similar between Group III and Group II. CONCLUSIONS: Methyl palmitate exhibited anti-inflammatory effects by resolving the histological changes and reducing the interleukin-5 levels in murine model of chronic asthma.


Subject(s)
Airway Remodeling/drug effects , Asthma/pathology , Lung/drug effects , Palmitates/pharmacology , Animals , Asthma/chemically induced , Asthma/immunology , Dexamethasone/pharmacology , Disease Models, Animal , Female , Glucocorticoids/pharmacology , Interleukin-5/immunology , Lung/immunology , Lung/pathology , Mice , Mice, Inbred BALB C , Ovalbumin/toxicity
7.
Nucl Med Commun ; 35(3): 260-7, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24468852

ABSTRACT

OBJECTIVE: Our objective was to evaluate the diagnostic role of dual-phase (18)F-fluorodeoxyglucose ((18)F-FDG) PET/computed tomography (CT) in the characterization of solitary pulmonary nodules (SPNs). PATIENTS AND METHODS: A total of 48 SPNs in 48 patients were included in this retrospective study. The final diagnosis was confirmed histopathologically or by follow-up CT. Two PET/CT scans were performed: the first (early scan) was performed 1 h after injection and the second (delayed scan) was performed 2 h later. Standardized uptake values (SUVs) [early and delayed SUVmax and SUVmean adjusted to body weight, body surface area (BSA), lean body mass (LBM) and blood glucose level (Glc)], retention index and nodule-to-mediastinum (nodule activity/subcarinal region of interest activity) ratios were calculated, along with the receiver operating characteristic curve. Intraobserver and interobserver variabilities among nuclear medicine physicians were analysed for the two phases. RESULTS: Eighteen patients had malignant tumour, whereas 30 had benign lesions. The median (min-max) SUVmax was 1.5 (0.5-4.1) in the benign group and 3.6 (1.3-38) in the malignant group. With the threshold value of early SUVmax as 2.5 and 2.75 using the receiver operating characteristic curve, a sensitivity of 94-75%, specificity of 75-80% and an accuracy of 83-78% were calculated. With the same threshold values for delayed images, 94-100% sensitivity, 77-80% specificity and 83-88% accuracy were obtained. BSA-SUVmax, LBM-SUVmax and Glc-SUVmax did not show any advantage over other quantitative parameters in the SPN characterization. There was no variability in the results obtained between the two nuclear medicine physicians. CONCLUSION: Dual-phase PET/CT may increase the diagnostic potential of PET/CT in the characterization of SPNs. In this particular study group, a threshold value could not be determined for the retention index, but higher retention indices may show higher malignant potential in SPNs.


Subject(s)
Fluorodeoxyglucose F18 , Multimodal Imaging , Positron-Emission Tomography , Solitary Pulmonary Nodule/diagnostic imaging , Tomography, X-Ray Computed , False Negative Reactions , False Positive Reactions , Female , Humans , Male , Middle Aged , Observer Variation , ROC Curve , Retrospective Studies
8.
Kardiochir Torakochirurgia Pol ; 11(4): 445-51, 2014 Dec.
Article in English | MEDLINE | ID: mdl-26336468

ABSTRACT

AIM: To investigate the effectiveness of indirect computed tomography (CT) venography applied after pulmonary CT angiography to patients with suspected pulmonary embolism. MATERIAL AND METHODS: The study comprised 80 patients at high/moderate risk of pulmonary embolism (PE) according to the clinical findings. Computed tomography venography (CTV) was performed 3-3.5 minutes after taking pulmonary CTA images. Color Doppler ultrasonography (CDUS) of the lower extremities was applied to all patients before pulmonary CTA or within 24 hours after CTA. RESULTS: Pulmonary embolism was determined in a total of 19 patients (23%). Six patients had deep venous thrombosis on CTV examination even though the CDUS findings were normal. Accepting color Doppler ultrasonography findings as the gold standard, the sensitivity of CTV in determining deep vein thrombosis (DVT) was found to be 100%, specificity 91%, positive predictive value 60%, negative predictive value 100%, likelihood of giving a positive result 11.1, and likelihood of giving a negative result 0. There was a statistically significant good degree of correlation between the two methods (r = 0.741, p < 0.001). CONCLUSIONS: Computed tomography venography examination applied after pulmonary CTA is a fast imaging technique that has high diagnostic value and can be an alternative to CDUS, especially when CDUS is insufficient in application and evaluation.

9.
Clin Respir J ; 8(1): 55-62, 2014 Jan.
Article in English | MEDLINE | ID: mdl-23711298

ABSTRACT

INTRODUCTION: There is very few data on the epidemiological features of interstitial lung diseases (ILD) in the literature. These studies on this subject suffer from limited number of patients. OBJECTIVE: The goal of this study was to evaluate the epidemiological features of ILD in Turkey. METHODS: Fifty-four investigators, 31 centres in 19 cities from six regions of Turkey, participated in the study. Two thousand two hundred forty-five newly diagnosed patients (51.8% females), led by Turkish Thoracic Society Clinical Problems Study Group, enrolled in this prospective study. RESULTS: The mean age was 51.8 ± 16.7 years. The mean age among males was 50.5 ± 18.6 years and 53.0 ± 14.6 years among females (P < 0.001). 23.8% of the cases had ILD with known causes, while 39.4% were in granulomatous group, 23.7% were idiopathic, and 4.4% were in the unclassified group. Overall, histopathologically confirmed diagnosis rate was 40.4%. Sarcoidosis was the most common disease (37%), whereas cases with idiopathic pulmonary fibrosis (IPF) constituted 19,9% of patients. 53% of the sarcoidosis patients were females, and the ratio reaches to 75% under 50 years of age (for this group, IPF ratio is %3). In contrast, sarcoidosis and IPF ratios were equal in males (25%). Sarcoidosis was 8% in men over 50, while IPF was %45. CONCLUSION: The overall incidence of ILD in Turkey was computed to be 25.8/100,000.


Subject(s)
Lung Diseases, Interstitial/epidemiology , Adult , Aged , Female , Humans , Idiopathic Pulmonary Fibrosis/epidemiology , Incidence , Male , Middle Aged , Prospective Studies , Sarcoidosis, Pulmonary/epidemiology , Turkey/epidemiology
10.
Respir Med Case Rep ; 13: 16-8, 2014.
Article in English | MEDLINE | ID: mdl-26029551

ABSTRACT

INTRODUCTION: Malignant pleural mesothelioma (MPM) is a malignant of mesodermal neoplasm and arises from multipotential mesothelial or subserosal cells of the pleura, pericardium and peritoneum. CASE: A seventy five year-old male patient was admitted with chest and lower limb pain. He was a heavy smoker and exposed to environmental asbestos in his childhood. PET-CT scans showed multiple pathological FDG uptakes in lungs and other organs. Biopsies performed from lung and anterior thigh muscles were reported as epitheloid type malignant pleural mesothelioma. DISCUSSION: We emphasize that unexpected distant metastases can be observed in MPM and occasionally primary diagnosis can be determined by the biopsy of the metastatic regions. This case also points out the role of PET-CT in the staging of malign mesothelioma by determining different metastatic sites.

11.
Blood Coagul Fibrinolysis ; 24(2): 140-9, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23358198

ABSTRACT

Inherited thrombophilias are thought to play an important role in the cause of pulmonary embolism and its recurrence. Ninety of 281 patients objectively diagnosed as pulmonary embolism between 2006 and 2009 were included in the study. The screening for thrombophilia included mutations of factor V Leiden (FVL), prothrombin (PTM) G20210A, methylene tetrahydrofolate reductase C677T-A1298C, the serum levels of antithrombin III, protein C, protein S, factor VIII and activated protein C resistance. Forty-two male (46.7%) and 48 female (53.3%) patients had a mean age of 62.6 ±â€Š13.4 years. Patients with common thrombophilias comprised 30% of all cases (FVL: 19.1%, PTM G20210A: 3.4%, antithrombin III deficiency: 1.1%, protein C deficiency: 5.7%, protein S deficiency: 13.6%). A significant association between recurrence of pulmonary embolism (10 patients, 12.2%) and protein S deficiency was established (P = 0.040). Serum level of protein C was also significantly lower in the subgroup of recurrent pulmonary embolism (P = 0.049). FVL and PTM mutations were high in cancer patients; the presence of inherited thrombophilia was low with risk factors of surgery and immobilization. Genetic risk factors were high in patients with pulmonary embolism. Protein C and S deficiencies may play a role in pulmonary embolism recurrence. DVT or family history of pulmonary embolism was not found to be related to inherited thrombophilias. Surgery and immobilization were thought not to have priorities for detection of genetic risk factors. The high percentages of FVL and PTM mutations in cancer patients should be considered.


Subject(s)
Pulmonary Embolism/blood , Pulmonary Embolism/genetics , Thrombophilia/blood , Thrombophilia/genetics , Factor V/metabolism , Female , Humans , Male , Methylenetetrahydrofolate Reductase (NADPH2)/metabolism , Middle Aged , Prothrombin/metabolism , Pulmonary Embolism/enzymology , Risk Factors , Thrombophilia/enzymology
12.
Tuberk Toraks ; 60(4): 336-43, 2012.
Article in English | MEDLINE | ID: mdl-23289463

ABSTRACT

INTRODUCTION: The aim of this study is to assess the opinions of relatives about telling the lung cancer diagnosis to the patient and evaluate the implementation in our hospital. MATERIALS AND METHODS: A survey questionnaire was designed, and applied on nurses and physicians working in oncology care units, 4th-6th grade medical students, and relatives of cancer and non-cancer patients. RESULTS: Totally 347 (228 males, 119 females) participants (64 physicians, 100 nurses, 61 medical students, and 122 relatives of patients) with a mean age of 28 were enrolled in the study. 62.5% of doctors, 53.2% of nurses, 59.5% of medical students and 45.9% of relatives of lung cancer patients thought that the patient should be informed about his/her cancer diagnosis. 29.5% of the physicians told their patients about their diagnosis of cancer. Gender, age, abroad experience, academic career, speciality, and period of professional experience were not determined to have any impact on physician's opinion and clinical practices. CONCLUSION: It was determined that physicians care more about patients' right to be informed than other participating groups. Generally, although physicians agree that the diagnosis of cancer should be told to the patient, their routine clinical practices do not reflect this viewpoint.


Subject(s)
Attitude of Health Personnel , Disclosure , Lung Neoplasms/psychology , Nurses/psychology , Patients/psychology , Physicians/psychology , Adult , Family Relations , Female , Humans , Lung Neoplasms/diagnosis , Male , Nurse's Role , Physician's Role , Students, Medical/psychology , Surveys and Questionnaires
13.
South Med J ; 102(1): 30-5, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19077765

ABSTRACT

OBJECTIVES: To determine the predominant pulmonary function abnormality in overweight and moderately obese subjects and to evaluate the correlation between the severity of lung function impairment and the degree of obesity. METHODS: Fifty-three volunteers underwent physical examination, skin fold measurements, and standardized pulmonary function tests. Thirty-one women and 22 men with a mean age of 40.2 (18-66) years were studied. RESULTS: The reduction in functional residual capacity (FRC) and expiratory reserve volume (ERV) were the most common abnormalities in overweight and obese subjects. The reduction in static lung volume was correlated with the degree of obesity in women and men. Stepwise multiple regression coefficients were obtained separately for women and men. Subscapular skinfold was the best predictor in women for FRC and waist-to-hip ratio (WHR) and BMI were found the best for ERV. WHR was found predictive for forced vital capacity, total lung capacity, and FRC in men. CONCLUSIONS: The lung volumes are substantially affected in our overweight and obese subjects. This influence is focused on different parameters of respiratory functions in men and women in relation to body fat distribution.


Subject(s)
Body Fat Distribution , Lung Diseases/etiology , Obesity/complications , Obesity/physiopathology , Adolescent , Adult , Aged , Case-Control Studies , Electric Impedance , Female , Humans , Lung Diseases/physiopathology , Male , Middle Aged , Multivariate Analysis , Overweight/complications , Overweight/physiopathology , Regression Analysis , Respiratory Function Tests , Turkey , Waist-Hip Ratio
14.
Tumori ; 94(5): 765-8, 2008.
Article in English | MEDLINE | ID: mdl-19112958

ABSTRACT

Metastasis to the pituitary gland and iris is rarely seen in cancer patients. Breast cancer and lung cancer are the most common tumors that metastasize to these sites. Most lung cancer patients have non-small cell lung cancer and metastasis of small cell lung cancer to the pituitary gland and iris have been very rarely reported in the literature. Here we present a case of iris metastasis and pituitary gland metastasis which caused diabetes insipidus in a patient with small cell lung cancer.


Subject(s)
Carcinoma, Small Cell/secondary , Diabetes Insipidus/etiology , Iris Neoplasms/secondary , Lung Neoplasms/pathology , Pituitary Neoplasms/complications , Pituitary Neoplasms/secondary , Biopsy , Humans , Iris Neoplasms/diagnosis , Magnetic Resonance Imaging , Male , Middle Aged , Pituitary Neoplasms/diagnosis , Tomography, X-Ray Computed
15.
Tuberk Toraks ; 56(1): 96-9, 2008.
Article in Turkish | MEDLINE | ID: mdl-18330762

ABSTRACT

Cyst hydatid disease (CHD) can be localized in every organ and frequently seen in Turkey. Twenty weeks pregnant woman was admitted with hemoptysis and dyspnea. Chest X-ray revealed bilateral homogeneous dansities. We planned to end pregnancy or follow until term, as diagnosis of CHD. The patient refused delivery. Eleven months later she was admitted with haemoptysis and syncope. Chest X-ray showed cavitary lesion, pleural effusion, pneumothorax in right lung and another cavitary lesion in left. Tube thoracostomy performed with the diagnosis of perforated cyst hydatid (CH) and the patient operated. CH may enlarge in pregnancy. Cyst rupture can cause anaphylactic shock and hemoptysis. Pregnancy and CHD occur occasionally together and there is no consensus about treatment.


Subject(s)
Echinococcosis/diagnosis , Pregnancy Complications, Parasitic/diagnosis , Echinococcosis/complications , Echinococcosis/therapy , Female , Humans , Pregnancy , Pregnancy Complications, Parasitic/therapy , Treatment Refusal , Young Adult
16.
Surg Today ; 38(1): 1-4, 2008.
Article in English | MEDLINE | ID: mdl-18085355

ABSTRACT

Cervical mediastinoscopy (CM) is considered to be the gold standard for evaluating mediastinal lymph nodes. The aim of this study was to determine the diagnostic yield of computed tomography (CT) and CM for detecting enlarged mediastinal lymph nodes in non-malignant pulmonary diseases. We retrospectively investigated the correlation and differentiation between chest CT and CM findings in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), in 30 patients with granulomatous lung disease diagnosed by CM and isolated enlarged lymph nodes seen on CT scans. Biopsy tissues from the lymph nodes in stations right, 1, 2, 3, 4, and 7, were obtained for pathological examination. The 30 patients comprised 11 men (mean age 47.1 +/- 18.4 years) and 19 women (mean age 44.2 +/- 14.0 years). Radiological examination showed that the diagnostic value of stations 2 and 4 was particularly high. Thus, when CM is used for diagnostic purposes, the small lymph nodes in station 1, obtained by careful dissection of the higher mediastinal region, can be helpful. Generally, there is no absolute consistency between the findings of CM and CT. For this reason, obtaining samples from each station regardless of CT findings is recommended.


Subject(s)
Lung Diseases/complications , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymphatic Diseases/diagnosis , Mediastinoscopy/methods , Tomography, X-Ray Computed/methods , Adult , Diagnosis, Differential , Female , Follow-Up Studies , Humans , Lung Diseases/diagnosis , Lymphatic Diseases/etiology , Male , Mediastinum , Middle Aged , Predictive Value of Tests , Retrospective Studies , Severity of Illness Index
17.
Tuberk Toraks ; 55(2): 174-81, 2007.
Article in Turkish | MEDLINE | ID: mdl-17602346

ABSTRACT

Pulmonary embolism (PE) is difficult to diagnose. We investigated the relationship between computed tomography pulmonary angiography (CTPA) with clinical assessments and thrombus localization. 56 patients with the suspicion of PE; 27 male, 29 female were included. They were evaluated by empirical and Wells clinical assessments, tested with D-Dimer. According to the combination of both CTPA was performed where necessary (if one of the clinical assessments was high or intermediate or those with low clinical probability and high D-Dimer) in the algorithm we used. CTPA was regarded as gold standard. Dyspnea, chest pain, tachypnea, crackles were the most common symptoms and signs in patients having PE. Recent surgery within the risk factors was significantly higher in the PE present group. PE was diagnosed in 31 (55.4%) patients with CTPA. According to the empirical assessment 20 (64.5%) of the patients had high, 10 (32.3%) had intermediate and 1 (3.2%) had low clinical probability within 31 PE present group, while with Wells scoring 8 (25.8%) had high, 17 (54.8%) had intermediate and 6 (19.4%) had low clinical probability. Sensitivity of the empirical assessment and Wells scoring was 97%, 80% while the specificity was 16%, 68% respectively. Positive and negative predictive values of empirical assessment were 59%, 80% and these values of Wells scoring were 76%, 73% respectively. Thrombus was localized in main pulmonary arteries in 45.8% of patients with high clinical probability according to the empirical assessment. With Wells scoring in 45.5% of the high probability patients and only in 4.3% of the low probability patients thrombus was there. PE can be diagnosed noninvasively. Since PE can easily be underdiagnosed, empirical assessment which is more sensitive will be appropriate. There is a significant correlation between clinical assessments and presence of PE in CTPA. As the severity of clinical assessment increases, thrombus settles more proximal.


Subject(s)
Angiography , Pulmonary Embolism/diagnostic imaging , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Pulmonary Embolism/pathology , Sensitivity and Specificity , Severity of Illness Index
18.
Tuberk Toraks ; 54(3): 249-53, 2006.
Article in Turkish | MEDLINE | ID: mdl-17001542

ABSTRACT

Between 2001-2002; in 62 cases, 33 (53%) male, 29 (47%) female, mean age 51.4 +/- 18.1 years) bronchoalveolar lavage (BAL) was performed for diagnosis of opportunistic pulmonary infection and specimens were evaluated for results of microbiological examinations. There was hematological malignancy in 18 (29%) and solid organ malignancy in 13 (21%) cases. Thirty-one (50%) cases were immunocompromised for reasons other than malignancy. By endoscopic evaluation endobronchial lesion was seen in 2 (3%) cases, indirect tumor signs were seen in 2 (3%) cases and signs of infection were seen in 11 (18%) cases. Forty-even (76%) cases were endoscopically normal. Acid-fast bacilli (AFB) direct examination was positive in 3 (5%) cases. In 4 (6%) cases mycobacterial culture was positive, Mycobacterium tuberculosis-polymerase chain reaction (PCR) was also positive in these four cases. Examination of gram-stained smears for bacteria was associated with infection in 14 (23%) cases. Bacteriologic cultures were positive for single potential pathogen in 10 (16%) cases, and for mixed pathogens in 7 (11%) cases for a total number of 17 (27%). Fungal cultures were positive in 3 (5%) cases all of which had hematological malignancy. As a result in 24 (39%) cases microbiological agent of infection is determined: in four mycobacteria, in 17 bacteria other than mycobacteria and in three fungi.


Subject(s)
Bronchoalveolar Lavage Fluid/microbiology , Immunocompromised Host , Lung Diseases/diagnosis , Opportunistic Infections/diagnosis , Bronchoscopy , Female , Humans , Lung Diseases/complications , Lung Diseases/microbiology , Lung Diseases/pathology , Lung Diseases, Fungal/complications , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/microbiology , Lung Diseases, Fungal/pathology , Male , Middle Aged , Mitosporic Fungi/isolation & purification , Mycobacterium tuberculosis/isolation & purification , Opportunistic Infections/complications , Opportunistic Infections/microbiology , Opportunistic Infections/pathology , Predictive Value of Tests , Tuberculosis, Pulmonary/complications , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/microbiology , Tuberculosis, Pulmonary/pathology
20.
Tuberk Toraks ; 54(4): 355-62, 2006.
Article in Turkish | MEDLINE | ID: mdl-17203422

ABSTRACT

Bronchiectasis is characterized with irreversible dilatation according to destruction of epithelium, elastic and muscular layer. Most important cause of bronchiectasis is chronic bacterial infections. Pseudomonas aeruginosa colonisation is frequently seen in bronchiectatic patients. We aimed to find out P. aeruginosa colonisation frequency and clinical, radiological and spirometric reflections due to colonisation. We analysed 83 cases retrospectively. Mean age was 58.2 and 54.2% of them were female. Bronchiectasis were localised 19.3% in left lung, 19.3% right and 61.4% bilaterally. 29 (35.8%) normal, 28 (34.6%) obstructive, 7 (8.6%) restrictive, 17 (21%) mixed type disorders are detected in spirometric measures. Sputum culture performed in 50 cases. No microorganism colonisation determined in 30 (60%) cases, P. aeruginosa colonisation 16 (32%), Haemophilus influenzae 2 (4%), 1 (2%) Streptococcus pneumoniae and Proteus mirabilis 1 (2%) cases. P. aeruginosa colonisation determined more frequent in males (p<0.05). No significant correlation detected between colonisation and age or smoking habits (p>0.05). In cases with colonisation; clubbing and hemoptysis were significantly frequent (p<0.05). Only peribronchial thickening was significantly correlated with colonisation in radiological findings (p<0.05). In blood gase analysis PaO2, oxygen saturation were lower and PaCO2 higher in cases colonised with P. aeruginosa but it was not statisticaly significant (p>0.05). Hospitalization rate was higher in P. aeruginosa colonised cases (p>0.05). It is an important problem about mortality because of higher hemoptysis and hospitalisation requirement rate in P. aeruginosa colonised cases.


Subject(s)
Bronchiectasis/epidemiology , Bronchiectasis/microbiology , Pseudomonas Infections/epidemiology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/isolation & purification , Adult , Aged , Aged, 80 and over , Bronchiectasis/etiology , Female , Hospitalization , Humans , Male , Medical Records , Middle Aged , Pseudomonas Infections/etiology , Retrospective Studies , Turkey/epidemiology
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