Leptin levels in various manifestations of pulmonary tuberculosis.

BACKGROUND: Proinflammatory cytokines are prime candidates as causative agents of the metabolic changes that eventually result in tuberculosis-associated weight loss. Microbial products and cytokines such as TNF and IL-1 increase leptin expression dose dependently in adipose tissue. Leptin plays an important role in cellular immunity. OBJECTIVES: In this study, we investigated serum leptin and TNF-alpha levels before and after antituberculosis therapy in patients with active pulmonary tuberculosis (TB). METHODS: Twenty five in patients with active pulmonary TB and 18 healthy controls participated in the study. Leptin and TNF-alpha levels were measured before treatment and six months after the treatment and they were compared with the control group. Body mass index (BMI) and chest X-rays before and after the treatment were also evaluated. RESULTS: The leptin levels before and after the treatment were 1.66+/-1.68 ng/mL and 3.26+/-3.81 ng/mL, respectively. The leptin levels of tuberculous patients were significant than in healthy patients (P < .05). The BMI was 19.36+/-2.55 kg/m2 before the treatment and 22.87+/-3.13 kg/m2 after the treatment. The TNF-alpha level was 23.19+/-12.78 pg/mL before the treatment and 15.95+/-6.58 pg/mL after the treatment. There was no correlation between leptin and TNF-alpha levels. Leptin levels were low in patients who had sequela lesion on chest radiographs. CONCLUSION: Leptin levels are suppressed in tuberculous patients and low leptin levels may contribute to increased susceptibility to infection and recovery with sequela lesions.

Investigation of micronucleus frequencies in lymphocytes of inhabitants environmentally exposed to chrysotile asbestos.

Exposure to asbestos minerals has been associated with a wide variety of adverse health effects including lung cancer, pleural mesothelioma, and cancer of other organs. Many of the regions of Turkey have asbestos deposits. People in Doganli village - one of these regions - have been environmentally exposed to chrysotile asbestos since they were born. In this study the effects of asbestos on micronucleus (MN) frequencies of inhabitants exposed to chrysotile asbestos have been examined. Thirty subjects who had been environmentally exposed to chrysotile asbestos and living in Doganli village, and 25 controls were studied to assess the MN frequency. The control group was selected from healthy individuals with no exposure to asbestos and living in similar geographic conditions to Doganli village. Peripheral blood samples were collected from each subject and cultured for MN assay. Cytochalasin-B was added to lymphocyte cultures for evaluation of MN in binucleated (BN) cells. The differences between those exposed to chrysotile asbestos and controls were not statistically significant in terms of BN cells with MN (p > 0.05). There was not a significant relationship between MN frequencies and age, sex, smoking, both in chrysotile asbestos-exposed subjects and in controls (p > 0.05). Although the detection of calcified pleural plaques found in the inhabitants has indicated environmental exposure to chrysotile asbestos, our results show that chrysotile asbestos was not an inducer of MN in subjects exposed to chrysotile asbestos.

Bronchiolitis obliterans organizing pneumonia. Clinical and roentgenological features in 26 cases.

BACKGROUND: Bronchiolitis obliterans organizing pneumonia (BOOP) may be classified as cryptogenic (idiopathic) and secondary. There are no clear clinical and radiological features distinguishing between idiopathic and secondary BOOP. OBJECTIVES: To analyze the etiologic factors, clinical and radiological features, diagnostic approach and response to therapy at onset and outcome in subjects with BOOP. METHODS: The medical files of Erciyes University Hospital from 1995 to 2003 were retrospectively reviewed. Patients with biopsy-proven BOOP were selected for evaluation. The etiology and initial features of BOOP, treatment, resolution, relapse, and survival were obtained from medical records, and a follow-up patient questionnaire. RESULTS: We have diagnosed 26 cases (13 males /13 females) with BOOP syndrome (mean age 54 +/- 15 years, range 14-93). More than half the patients (58%) were classified as idiopathic BOOP. Patients presented with cough (92%), dyspnea (70%), pleuritic chest pain, hemoptysis and fever (50%). The biopsy specimens had been obtained by transbronchial and/or transthoracic lung biopsy in 18 cases (69%). At radiological evaluation, there were bilateral patchy alveolar and/or interstitial infiltrates in 16 patients (62%), and solitary pneumonic involvement in 10 patients (38%). Three patients recovered spontaneously, 5 remained cured after resection of the focal lesion. Corticosteroid therapy was given in 17 patients (65%). Apart from four patients who died (death was attributable to BOOP in only 1 patient) and three patients who relapsed, the prognosis was good in all patients. CONCLUSIONS: The etiology of BOOP is usually idiopathic. We observed that hemoptysis and pleuritic chest pain were a relatively frequent symptom in BOOP in the present series, in contrast to previous observations. The diversity of radiological and clinical presentations including hemotysis and pleuritic chest pain should prompt consideration of the diagnosis in patients with persisting pulmonary symptoms and radiological findings.

Tracheobronchopathia osteochondroplastica: two cases and review of literature.

Tracheobronchopathia osteochondroplastica (TO) is an unusual disorder. It mainly affects men over 50 years old and clinical manifestations are observed when obstructive or infectious complications occur. A 50-year old woman was investigated because of productive cough and 42 years old man was investigated because of haemoptysis. In two cases, at bronchoscopy, the typical picture of TO was observed. Microscopic examination of the biopsy material revealed bone formation. TO should be considered in the differential diagnosis as an unusual cause of chronic persistent cough, haemoptysis, persistent atelectasis, and recurrent segmental or lobar infection.

[Pulmonary and chest wall involvement in multiple myeloma]. / Multipl Miyelomada Akciger ve Gögüs Duvari Tutulumu.

Multiple myeloma (MM) may manifest as diffuse bony disease (myelmatosis), as a solitary plasmacytoma of bone, or as extramedullary (extraosseous) plasmacytoma (EMP). The most frequent thoracic involvement by MM is bone involvement or pulmonary infiltrate secondary to an infectious process. Because MM, which is a disorder of the aged population, with its severe clinical course and heterogeneous symptoms, the diagnosis is difficult. The aim of this study was to investigate the causes, the frequency and the effects of prognosis of the pulmonary involvement in 38 patients with this disorder who were treated between January 1995 and April 2001 at the Department of Chest and Haematology-Oncology at Erciyes University Medical School. The patients with MM; 25 (66%) was male and 13 (34%) was female, and their mean age was 61 +/- 11 range 40-80 years. Of the 38 patients; 19 (50%) had thoracal involvement which included pulmonary involvement in 13 (%35) and thoracal bone invasion in 9 (24%). According to their clinical and radiological findings, the 13 cases with pulmonary involvement were evaluated and six had pneumonia, two had mass lesion, two had multiple nodular lesion, three had intersitial infiltration. Five (13%) of the patients with respiratory symptoms were admitted to the Chest Clinic. Malign plasma cell infiltration was detected by transthoracal lung biopsy in two patients with mass lesions, and with transbronchial lung biopsy in one patient with intersitial infiltration. The cases with pulmonary involvement were associated with progressive diseases, which included mainly renal failure and pathological bone fractures. Pulmonary involvement of MM is frequently associated with rapid progression of the disease and demonstrates the variability of roentgenographic manifestations. MM should be taken into consideration in the differential diagnosis of pulmonary infiltration in older patients with systemic complaints.