Background: Patients who have successful return of spontaneous circulation after cardiac arrest m... more Background: Patients who have successful return of spontaneous circulation after cardiac arrest may experience post-cardiac arrest syndrome. Procalcitonin can be used to assess the severity of post-cardiac arrest syndrome. The association between procalcitonin and outcomes in Asian patients with post-cardiac arrest syndrome has not been extensively studied. Objective: This study aimed to investigate the predictive value of serum procalcitonin level in the prognosis of patients hospitalized after out-of-hospital cardiac arrest. Methods: A retrospective observational study using the multicenter Korean Cardiac Arrest Research Consortium registry between October 2015 and June 2018 was performed. Serum procalcitonin level at the early phase of hospital presentation was obtained from the patients hospitalized after out-of-hospital cardiac arrest. In-hospital mortality and neurologic outcomes at hospital discharge were estimated. The relationship between serum procalcitonin level and in-ho...
Chronic obstructive pulmonary diseases are common causes of disease in the community and account ... more Chronic obstructive pulmonary diseases are common causes of disease in the community and account for considerable percent of the caseload in primary health care facilities. For this reason, it is important to question and improve the knowledge of primary health care physicians. This study is designed to assess the level of knowledge for bronchial asthma and COPD of the primary healthcare physicians, both before and immediately after an educational course structured in the context of GARD Chronic Airway Diseases National Control Program. The participating physicians attended an intensive educational course on asthma and COPD. Twenty five item questionnaires for asthma and COPD were administered to the participants both before and immediately after the end of the course. Contribution of education to the level of knowledge was investigated by comparing the percentages of the correct answers in the pre-and post-test. From 11 different cities, 1817 and 1788 primary health care physician ...
The aim of this study was to evaluate whether combined use of cetrimide-chlorexidine and hyperton... more The aim of this study was to evaluate whether combined use of cetrimide-chlorexidine and hypertonic sodium chloride as scholexidal agents leads to complications in liver, lung or biliary tract. Thirty Spregue-Dowley rats weighing 100 10 gr were used in this study. Rats were divided into two groups. Fifteen rats in group I were injected with 10% hypertonic sodium chloride, whereas 15 rats ingroup II were injected 0.5% cetrimide-0.05% chlorhexidine combination. After 5 cc blood aspiration by intracardiac punction, liver, choledoc canal and lungs were taken out en-bloc. Liver SOD, MDA, GSH-Px were studied at the department of pharmacology. Sixteen rats, which survived after the operation for 120 days, were put to sleep. The specimens from liver and lung parenchyma were evaluated. In this study, histopathological evaluation of liver tissue in group I was found to be sclerosing cholangitis, whereas in group II, moderate stress factors in liver tissue was noticed. In this experimental study, we found that the administration of 0.5% cetrimide-0.05% chlorhexidine combination as a scholexidal agent into the biliary tract instead of a protoscoleces agent is a safe approach.
Aim of this study is to determine the diagnostic value of pulmonary angiography performed by eith... more Aim of this study is to determine the diagnostic value of pulmonary angiography performed by either single-detector row CT (SDCT) or multi-detector row CT (MDCT) in patients suspected of venous thromboembolism (VTE). SDCT was performed on 36 and MDCT on 18 of total of 54 patients on whom V/Q scintigraphy was obtained with a suspicion of VTE. Sixteen out of 54 cases got additional pulmonary DSA. Statistical analyses were based on final clinical diagnoses of the individual cases. Twenty-six out of 54 cases in the study got the final diagnoses of VTE and VTE was certainly excluded in the remaining 28. Sixteen out of true 26 VTE cases were in the SDCT group while the other 10 cases took place in the MDCT group, none of which was missed by either technique. There was one false positive result in the SDCT group and none in the MDCT group (96% and 100% specificity respectively, 100% sensitivity for both). Only 9% of all pulmonary emboli detected by SDCT assisted pulmonary angiography were ...
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2006
A 54-year-old male patient with 17 months history of percutaneous drainage of type-II hydatid cys... more A 54-year-old male patient with 17 months history of percutaneous drainage of type-II hydatid cyst located in the right lobe of the liver was admitted with fever, right hypochondrial pain, loss of appetite, malaise, weight loss, jaundice and dyspnea with green-yellow-colored ...
Respiratory system disease itself can cause malnutrition, while nutritional status can be the cau... more Respiratory system disease itself can cause malnutrition, while nutritional status can be the cause of or enhance respiratory failure. Malnutrition which exists 27-71 percent in chronic obstructive pulmonary disease, is a factor that determines functional capacity and mortality.
The fraction of lung voxels below a pixel value "cut-off" has been correlated with path... more The fraction of lung voxels below a pixel value "cut-off" has been correlated with pathologic estimates of emphysema. We performed a "standard" quantitative CT (QCT) lung analysis using a -950 HU cut-off to determine the volume fraction of emphysema (below the cut-off) and a " ...
COPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic cate... more COPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic categorization of a high-risk population has many potential benefits. The present study uses a symptom questionnaire, low-dose computed tomography (LDCT) and pulmonary function tests (PFT) to phenotypically subgroup a high-risk population. Study group consisted of current or former smokers who underwent lung cancer screening with LDCT as a subgroup of Pittsburgh Lung Screening Study. In addition to LDCT, PFT and a symptom query questionnaire were obtained from each patient. The study group consisted of 3183 subjects (age 50-79) subdivided into eight groups according to presence of symptoms, obstruction on PFT and presence of emphysema on LDCT. A total of 501 (15.7%) subjects were asymptomatic, with no airflow obstruction or evidence of emphysema. There were 866 (27.2%) subjects with both obstruction on PFT and emphysema on LDCT, but only 660 (20.7%) had symptoms. Five hundred thirty (16.6%) ...
It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-ye... more It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-year-old male patient with diaphragmatic paralysis and tetraplegia due to spinal cord injury (SCI), and supporting effect of IMT in recovering from respiratory failure by rendering his diaphragm functions. The treatment was applied through the tracheostomy cannula by a modified IMT device. After applying IMT for three weeks, it was observed that the diaphragm recovered its functions in electromyography (EMG) test. As a result, in this study, we present a case where a patient could live without any respiratory device for the rest of his life with the help of modified IMT.
The aim of this study is to evaluate the incidence of interstitial pneumonitis following fraction... more The aim of this study is to evaluate the incidence of interstitial pneumonitis following fractionated total body irradiation conditioning for bone marrow transplantation with varying lung doses due to shielding technique and different dose-rates. Between 1987 and 2001, a total number of 105 patients have received total body irradiation conditioning for bone marrow transplantation for hematological malignancies at Gulhane Military Medical School. Twelve Gy fractionated total body irradiation was delivered in 6 fractions over 3 consecutive days with Co-60 teletherapy machine. Conditioning therapy included only cyclophosphamide (60 mg/ kg/day for two days) and total body irradiation. The median follow-up for patients was 12 months. Interstitial pneumonitis developed in 10 patients out of 105 patients (9.52%). The median total dose to lung was 9.60 Gy (8.88-10.90). The difference between total lung dose and interstitial pneumonitis was not significant. Pneumonitis development in the high dose-rate (>0.04 Gy/min) group versus low dose-rate (0.04 Gy/min) group was statistically significant. Low dose-rate fractionated total body irradiation is a reliable conditioning program in bone marrow transplantation with effective lung sparing to avoid interstitial pneumonitis. fractionated total body irradiation; dose-rate; interstitial pneumonitis; bone marrow transplantation
Background: The results of sputum culture for Mycobacterium tuberculosis must be awaited in most ... more Background: The results of sputum culture for Mycobacterium tuberculosis must be awaited in most cases, which delays the start of treatment in patients with sputum smear-negative pulmonary tuberculosis. We investigated whether plasma chitotriosidase activity is a strong marker for early diagnosis of tuberculosis in patients for whom a bacillus smear is negative and tuberculosis culture is positive. Methods: Clinical, radiological, and laboratory features were evaluated in 75 patients, 17 of whom were diagnosed as having active tuberculosis by negative acid-fast bacillus smear and positive culture, 38 as having sequel tuberculosis which was radiologically and microbiologically negative, and 20 who served as healthy controls. Serum chitotriosidase activity levels were measured in both cases and controls. Results: The mean age of the cases with active pulmonary tuberculosis, cases with sequel lesions, and controls was 23 ± 2.4 years, 22 ± 1.7 years, and 24 ± 2.1 years, respectively. Serum chitotriosidase levels were 68.05 ± 72.61 nmol/hour/mL in smear-negative, culture-positive pulmonary tuberculosis cases (Group A) and 29.73 ± 20.55 nmol/hour/mL in smear-negative, culture-negative sequel pulmonary tuberculosis cases (Group B). Serum chitotriosidase levels from patients in Group A were significantly higher than in Group B and Group C. There was no statistically significant difference in serum chitotriosidase levels between cases with sequel pulmonary tuberculosis (Group B, smear-negative, culture-negative) and healthy controls (Group C). Conclusion: In patients with active tuberculosis and a negative sputum smear for acid-fast bacillus, plasma chitotriosidase activity seems to be a strong marker for diagnosis of active disease which can be used while awaiting culture results.
We report a patient having disseminated tuberculosis (TB) with negative smear and culture for Myc... more We report a patient having disseminated tuberculosis (TB) with negative smear and culture for Mycobacterium tuberculosis, left testicular mass, and an increase in tumour markers; alphafetoprotein (AFP), CA-125, and CA-19-9. The patient was a 53-year-old Caucasian male, presented with night sweat, weakness, and weight loss. Radiological findings were compatible with tuberculosis, however, sputum, bronchoalveolar lavage and biopsy materials were negative for malignancy or tuberculosis. A testicular mass was detected during the physical examination and orchidectomy material revealed acid-fast bacilli containing caseating granuloma. The patient responded well to anti-tuberculous therapy; clinical and radiological improvements observed at the end of the treatment period. Tumour markers were also decreased.
Both of the diagnosis and treatment evaluation are time-consuming conditions in patients with pul... more Both of the diagnosis and treatment evaluation are time-consuming conditions in patients with pulmonary and pleural tuberculosis. The aim of this study was to establish the validity of tumor markers CA 125, CA 15-3, and CA 19-9 in the diagnosis of pulmonary and pleural TB and to verify the success of the treatment protocol. Patients and methods: The levels of tumor markers CA 125, CA 15-3, and CA 19-9 were measured before and after treatment in 67 TB patients, 54 of whom had pulmonary TB and 13 of whom had pleural TB. All values were compared with the results of a healthy control group of 44 subjects. Results: CA 125 and CA 15-3 levels were significantly high when compared with those of the healthy control group and there was a significant decrease in both tumor marker levels after treatment in patients with pulmonary TB (P , 0.001 and P , 0.004, respectively). However, the difference found in CA 19-9 levels before and after treatment in patients with pulmonary TB was not statistically significant (P , 0.08). When the CA 125, CA 15-3, and CA 19-9 values of the pulmonary TB group before treatment were compared with that of the healthy control group, the results were statistically significant in all parameters except CA 19-9 (P , 0.001, P , 0.001, and P , 0.09 for CA 125, CA 15-3, and CA 19-9, respectively). In the patients with pleural TB, CA 125, CA 15-3, and CA 19-9 values did not change significantly after treatment. Conclusion: The authors suggest that CA 125 and CA 15-3 tumor markers may be important for verification of the success of treatment protocol in pulmonary TB, as the differences found for these tumor markers between the pre-and the posttreatment periods are statistically significant.
Background: Chronic obstructive pulmonary disease is still one of the most important problems in ... more Background: Chronic obstructive pulmonary disease is still one of the most important problems in patients undergoing cardiopulmonary bypass. The purpose of this prospective study was to assess the beneficial effects of oral prednisolone on pulmonary functions in patients undergoing cardiopulmonary bypass. Methods: Forty patients with chronic obstructive pulmonary disease were divided into two groups randomly and were given 20 mg oral prednisolone once daily perioperatively (Group I, n = 20) or identical placebo (Group II, n = 20). FEV 1 values, dates of intensive care unit and hospital stays of the two groups were compared. Results: FEV 1 values during the admission to our hospital were similar in each group mean predicted FEV 1 : 56.7 ± 5.35% in Group I and 57.2 ± 4.88% in Group II (p = 0.759). After 10 days of oral prednisolone treatment in Group I, predicted FEV 1 values were significantly different between two groups (63.2% ± 4.24 and 57.9% ± 4.38) (p = 0.0001). While predicted FEV 1 values revealed difference between two groups at the date of discharge (p = 0.0001) the values became similar at the third month (55.6% ± 4.09 in Group I and 55.45% ± 3.87 in Group II) (p = 0.897). Conclusion: Various types of complications may occur after cardiopulmonary bypass. Oral prednisolone not only decreases the rates of complications (reintubation, intubation times, and rhythm disturbances) but also decreases the cost of cardiac operations according to shorter hospital stays.
Pulmonary endometriosis is a rare cause of hemoptysis. The main manifestations are catamenial hem... more Pulmonary endometriosis is a rare cause of hemoptysis. The main manifestations are catamenial hemoptysis during the first days of the menses. A 29-year-old woman with 2-year history of hemoptysis during menstrual period underwent endometrial curettage in 1997 and had childbirth in 1998. Both computed tomography and high resolution computed tomography before and after menstruation showed peripheral nodular lesions 1.0-cm diameter with cavitary or bullous formation in both pulmonary parenchymas. The diagnosis was confirmed clinically. Symptoms disappeared absolute years follow up after hormone therapy.
Tuberculosis (TB) is a disease that has afflicted mankind for thousands of years, but in the last... more Tuberculosis (TB) is a disease that has afflicted mankind for thousands of years, but in the last seven decades, much progress has been made in anti-TB therapy. Early drugs, such as paraaminosalicylic acid, streptomycin, isoniazid, and rifamycins were very effective in combatting the disease, giving rise to the hope that TB would be eradicated from the face of the earth by 2010. Despite that optimism, TB continues to kill more than a million people annually worldwide. A major reason for our inability to contain TB is the emergence drug resistance in Mycobacterium tuberculosis. This commentary is based on our recent publication on the structure of L,D-transpeptidase enzyme, relevant to drug resistance. As a background, we briefly outline the history and development of anti-TB therapy. Based on the crystal structure, we suggest a potential direction for designing more potent drugs against TB.
American Journal of Respiratory and Critical Care Medicine, 2008
Rationale: To study the relationship between emphysema and/or airflow obstruction and lung cancer... more Rationale: To study the relationship between emphysema and/or airflow obstruction and lung cancer in a high-risk population. Objective: We studied lung cancer related to radiographic emphysema and spirometric airflow obstruction in tobacco-exposed persons who were screened for lung cancer using chest computed tomography (CT). Methods: Subjects completed questionnaires, spirometry, and lowdose helical chest CT. CT scans were scored for emphysema based on National Emphysema Treatment Trial criteria. Multiple logistic regressions estimated the independent associations between various factors, including radiographic emphysema and airflow obstruction, and subsequent lung cancer diagnosis.
Background: Patients who have successful return of spontaneous circulation after cardiac arrest m... more Background: Patients who have successful return of spontaneous circulation after cardiac arrest may experience post-cardiac arrest syndrome. Procalcitonin can be used to assess the severity of post-cardiac arrest syndrome. The association between procalcitonin and outcomes in Asian patients with post-cardiac arrest syndrome has not been extensively studied. Objective: This study aimed to investigate the predictive value of serum procalcitonin level in the prognosis of patients hospitalized after out-of-hospital cardiac arrest. Methods: A retrospective observational study using the multicenter Korean Cardiac Arrest Research Consortium registry between October 2015 and June 2018 was performed. Serum procalcitonin level at the early phase of hospital presentation was obtained from the patients hospitalized after out-of-hospital cardiac arrest. In-hospital mortality and neurologic outcomes at hospital discharge were estimated. The relationship between serum procalcitonin level and in-ho...
Chronic obstructive pulmonary diseases are common causes of disease in the community and account ... more Chronic obstructive pulmonary diseases are common causes of disease in the community and account for considerable percent of the caseload in primary health care facilities. For this reason, it is important to question and improve the knowledge of primary health care physicians. This study is designed to assess the level of knowledge for bronchial asthma and COPD of the primary healthcare physicians, both before and immediately after an educational course structured in the context of GARD Chronic Airway Diseases National Control Program. The participating physicians attended an intensive educational course on asthma and COPD. Twenty five item questionnaires for asthma and COPD were administered to the participants both before and immediately after the end of the course. Contribution of education to the level of knowledge was investigated by comparing the percentages of the correct answers in the pre-and post-test. From 11 different cities, 1817 and 1788 primary health care physician ...
The aim of this study was to evaluate whether combined use of cetrimide-chlorexidine and hyperton... more The aim of this study was to evaluate whether combined use of cetrimide-chlorexidine and hypertonic sodium chloride as scholexidal agents leads to complications in liver, lung or biliary tract. Thirty Spregue-Dowley rats weighing 100 10 gr were used in this study. Rats were divided into two groups. Fifteen rats in group I were injected with 10% hypertonic sodium chloride, whereas 15 rats ingroup II were injected 0.5% cetrimide-0.05% chlorhexidine combination. After 5 cc blood aspiration by intracardiac punction, liver, choledoc canal and lungs were taken out en-bloc. Liver SOD, MDA, GSH-Px were studied at the department of pharmacology. Sixteen rats, which survived after the operation for 120 days, were put to sleep. The specimens from liver and lung parenchyma were evaluated. In this study, histopathological evaluation of liver tissue in group I was found to be sclerosing cholangitis, whereas in group II, moderate stress factors in liver tissue was noticed. In this experimental study, we found that the administration of 0.5% cetrimide-0.05% chlorhexidine combination as a scholexidal agent into the biliary tract instead of a protoscoleces agent is a safe approach.
Aim of this study is to determine the diagnostic value of pulmonary angiography performed by eith... more Aim of this study is to determine the diagnostic value of pulmonary angiography performed by either single-detector row CT (SDCT) or multi-detector row CT (MDCT) in patients suspected of venous thromboembolism (VTE). SDCT was performed on 36 and MDCT on 18 of total of 54 patients on whom V/Q scintigraphy was obtained with a suspicion of VTE. Sixteen out of 54 cases got additional pulmonary DSA. Statistical analyses were based on final clinical diagnoses of the individual cases. Twenty-six out of 54 cases in the study got the final diagnoses of VTE and VTE was certainly excluded in the remaining 28. Sixteen out of true 26 VTE cases were in the SDCT group while the other 10 cases took place in the MDCT group, none of which was missed by either technique. There was one false positive result in the SDCT group and none in the MDCT group (96% and 100% specificity respectively, 100% sensitivity for both). Only 9% of all pulmonary emboli detected by SDCT assisted pulmonary angiography were ...
The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology, 2006
A 54-year-old male patient with 17 months history of percutaneous drainage of type-II hydatid cys... more A 54-year-old male patient with 17 months history of percutaneous drainage of type-II hydatid cyst located in the right lobe of the liver was admitted with fever, right hypochondrial pain, loss of appetite, malaise, weight loss, jaundice and dyspnea with green-yellow-colored ...
Respiratory system disease itself can cause malnutrition, while nutritional status can be the cau... more Respiratory system disease itself can cause malnutrition, while nutritional status can be the cause of or enhance respiratory failure. Malnutrition which exists 27-71 percent in chronic obstructive pulmonary disease, is a factor that determines functional capacity and mortality.
The fraction of lung voxels below a pixel value "cut-off" has been correlated with path... more The fraction of lung voxels below a pixel value "cut-off" has been correlated with pathologic estimates of emphysema. We performed a "standard" quantitative CT (QCT) lung analysis using a -950 HU cut-off to determine the volume fraction of emphysema (below the cut-off) and a " ...
COPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic cate... more COPD (chronic obstructive pulmonary disease) is a very heterogeneous disease, and phenotypic categorization of a high-risk population has many potential benefits. The present study uses a symptom questionnaire, low-dose computed tomography (LDCT) and pulmonary function tests (PFT) to phenotypically subgroup a high-risk population. Study group consisted of current or former smokers who underwent lung cancer screening with LDCT as a subgroup of Pittsburgh Lung Screening Study. In addition to LDCT, PFT and a symptom query questionnaire were obtained from each patient. The study group consisted of 3183 subjects (age 50-79) subdivided into eight groups according to presence of symptoms, obstruction on PFT and presence of emphysema on LDCT. A total of 501 (15.7%) subjects were asymptomatic, with no airflow obstruction or evidence of emphysema. There were 866 (27.2%) subjects with both obstruction on PFT and emphysema on LDCT, but only 660 (20.7%) had symptoms. Five hundred thirty (16.6%) ...
It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-ye... more It is aimed to present the usefulness of inspiratory muscle trainer (IMT) in treatment of a 20-year-old male patient with diaphragmatic paralysis and tetraplegia due to spinal cord injury (SCI), and supporting effect of IMT in recovering from respiratory failure by rendering his diaphragm functions. The treatment was applied through the tracheostomy cannula by a modified IMT device. After applying IMT for three weeks, it was observed that the diaphragm recovered its functions in electromyography (EMG) test. As a result, in this study, we present a case where a patient could live without any respiratory device for the rest of his life with the help of modified IMT.
The aim of this study is to evaluate the incidence of interstitial pneumonitis following fraction... more The aim of this study is to evaluate the incidence of interstitial pneumonitis following fractionated total body irradiation conditioning for bone marrow transplantation with varying lung doses due to shielding technique and different dose-rates. Between 1987 and 2001, a total number of 105 patients have received total body irradiation conditioning for bone marrow transplantation for hematological malignancies at Gulhane Military Medical School. Twelve Gy fractionated total body irradiation was delivered in 6 fractions over 3 consecutive days with Co-60 teletherapy machine. Conditioning therapy included only cyclophosphamide (60 mg/ kg/day for two days) and total body irradiation. The median follow-up for patients was 12 months. Interstitial pneumonitis developed in 10 patients out of 105 patients (9.52%). The median total dose to lung was 9.60 Gy (8.88-10.90). The difference between total lung dose and interstitial pneumonitis was not significant. Pneumonitis development in the high dose-rate (>0.04 Gy/min) group versus low dose-rate (0.04 Gy/min) group was statistically significant. Low dose-rate fractionated total body irradiation is a reliable conditioning program in bone marrow transplantation with effective lung sparing to avoid interstitial pneumonitis. fractionated total body irradiation; dose-rate; interstitial pneumonitis; bone marrow transplantation
Background: The results of sputum culture for Mycobacterium tuberculosis must be awaited in most ... more Background: The results of sputum culture for Mycobacterium tuberculosis must be awaited in most cases, which delays the start of treatment in patients with sputum smear-negative pulmonary tuberculosis. We investigated whether plasma chitotriosidase activity is a strong marker for early diagnosis of tuberculosis in patients for whom a bacillus smear is negative and tuberculosis culture is positive. Methods: Clinical, radiological, and laboratory features were evaluated in 75 patients, 17 of whom were diagnosed as having active tuberculosis by negative acid-fast bacillus smear and positive culture, 38 as having sequel tuberculosis which was radiologically and microbiologically negative, and 20 who served as healthy controls. Serum chitotriosidase activity levels were measured in both cases and controls. Results: The mean age of the cases with active pulmonary tuberculosis, cases with sequel lesions, and controls was 23 ± 2.4 years, 22 ± 1.7 years, and 24 ± 2.1 years, respectively. Serum chitotriosidase levels were 68.05 ± 72.61 nmol/hour/mL in smear-negative, culture-positive pulmonary tuberculosis cases (Group A) and 29.73 ± 20.55 nmol/hour/mL in smear-negative, culture-negative sequel pulmonary tuberculosis cases (Group B). Serum chitotriosidase levels from patients in Group A were significantly higher than in Group B and Group C. There was no statistically significant difference in serum chitotriosidase levels between cases with sequel pulmonary tuberculosis (Group B, smear-negative, culture-negative) and healthy controls (Group C). Conclusion: In patients with active tuberculosis and a negative sputum smear for acid-fast bacillus, plasma chitotriosidase activity seems to be a strong marker for diagnosis of active disease which can be used while awaiting culture results.
We report a patient having disseminated tuberculosis (TB) with negative smear and culture for Myc... more We report a patient having disseminated tuberculosis (TB) with negative smear and culture for Mycobacterium tuberculosis, left testicular mass, and an increase in tumour markers; alphafetoprotein (AFP), CA-125, and CA-19-9. The patient was a 53-year-old Caucasian male, presented with night sweat, weakness, and weight loss. Radiological findings were compatible with tuberculosis, however, sputum, bronchoalveolar lavage and biopsy materials were negative for malignancy or tuberculosis. A testicular mass was detected during the physical examination and orchidectomy material revealed acid-fast bacilli containing caseating granuloma. The patient responded well to anti-tuberculous therapy; clinical and radiological improvements observed at the end of the treatment period. Tumour markers were also decreased.
Both of the diagnosis and treatment evaluation are time-consuming conditions in patients with pul... more Both of the diagnosis and treatment evaluation are time-consuming conditions in patients with pulmonary and pleural tuberculosis. The aim of this study was to establish the validity of tumor markers CA 125, CA 15-3, and CA 19-9 in the diagnosis of pulmonary and pleural TB and to verify the success of the treatment protocol. Patients and methods: The levels of tumor markers CA 125, CA 15-3, and CA 19-9 were measured before and after treatment in 67 TB patients, 54 of whom had pulmonary TB and 13 of whom had pleural TB. All values were compared with the results of a healthy control group of 44 subjects. Results: CA 125 and CA 15-3 levels were significantly high when compared with those of the healthy control group and there was a significant decrease in both tumor marker levels after treatment in patients with pulmonary TB (P , 0.001 and P , 0.004, respectively). However, the difference found in CA 19-9 levels before and after treatment in patients with pulmonary TB was not statistically significant (P , 0.08). When the CA 125, CA 15-3, and CA 19-9 values of the pulmonary TB group before treatment were compared with that of the healthy control group, the results were statistically significant in all parameters except CA 19-9 (P , 0.001, P , 0.001, and P , 0.09 for CA 125, CA 15-3, and CA 19-9, respectively). In the patients with pleural TB, CA 125, CA 15-3, and CA 19-9 values did not change significantly after treatment. Conclusion: The authors suggest that CA 125 and CA 15-3 tumor markers may be important for verification of the success of treatment protocol in pulmonary TB, as the differences found for these tumor markers between the pre-and the posttreatment periods are statistically significant.
Background: Chronic obstructive pulmonary disease is still one of the most important problems in ... more Background: Chronic obstructive pulmonary disease is still one of the most important problems in patients undergoing cardiopulmonary bypass. The purpose of this prospective study was to assess the beneficial effects of oral prednisolone on pulmonary functions in patients undergoing cardiopulmonary bypass. Methods: Forty patients with chronic obstructive pulmonary disease were divided into two groups randomly and were given 20 mg oral prednisolone once daily perioperatively (Group I, n = 20) or identical placebo (Group II, n = 20). FEV 1 values, dates of intensive care unit and hospital stays of the two groups were compared. Results: FEV 1 values during the admission to our hospital were similar in each group mean predicted FEV 1 : 56.7 ± 5.35% in Group I and 57.2 ± 4.88% in Group II (p = 0.759). After 10 days of oral prednisolone treatment in Group I, predicted FEV 1 values were significantly different between two groups (63.2% ± 4.24 and 57.9% ± 4.38) (p = 0.0001). While predicted FEV 1 values revealed difference between two groups at the date of discharge (p = 0.0001) the values became similar at the third month (55.6% ± 4.09 in Group I and 55.45% ± 3.87 in Group II) (p = 0.897). Conclusion: Various types of complications may occur after cardiopulmonary bypass. Oral prednisolone not only decreases the rates of complications (reintubation, intubation times, and rhythm disturbances) but also decreases the cost of cardiac operations according to shorter hospital stays.
Pulmonary endometriosis is a rare cause of hemoptysis. The main manifestations are catamenial hem... more Pulmonary endometriosis is a rare cause of hemoptysis. The main manifestations are catamenial hemoptysis during the first days of the menses. A 29-year-old woman with 2-year history of hemoptysis during menstrual period underwent endometrial curettage in 1997 and had childbirth in 1998. Both computed tomography and high resolution computed tomography before and after menstruation showed peripheral nodular lesions 1.0-cm diameter with cavitary or bullous formation in both pulmonary parenchymas. The diagnosis was confirmed clinically. Symptoms disappeared absolute years follow up after hormone therapy.
Tuberculosis (TB) is a disease that has afflicted mankind for thousands of years, but in the last... more Tuberculosis (TB) is a disease that has afflicted mankind for thousands of years, but in the last seven decades, much progress has been made in anti-TB therapy. Early drugs, such as paraaminosalicylic acid, streptomycin, isoniazid, and rifamycins were very effective in combatting the disease, giving rise to the hope that TB would be eradicated from the face of the earth by 2010. Despite that optimism, TB continues to kill more than a million people annually worldwide. A major reason for our inability to contain TB is the emergence drug resistance in Mycobacterium tuberculosis. This commentary is based on our recent publication on the structure of L,D-transpeptidase enzyme, relevant to drug resistance. As a background, we briefly outline the history and development of anti-TB therapy. Based on the crystal structure, we suggest a potential direction for designing more potent drugs against TB.
American Journal of Respiratory and Critical Care Medicine, 2008
Rationale: To study the relationship between emphysema and/or airflow obstruction and lung cancer... more Rationale: To study the relationship between emphysema and/or airflow obstruction and lung cancer in a high-risk population. Objective: We studied lung cancer related to radiographic emphysema and spirometric airflow obstruction in tobacco-exposed persons who were screened for lung cancer using chest computed tomography (CT). Methods: Subjects completed questionnaires, spirometry, and lowdose helical chest CT. CT scans were scored for emphysema based on National Emphysema Treatment Trial criteria. Multiple logistic regressions estimated the independent associations between various factors, including radiographic emphysema and airflow obstruction, and subsequent lung cancer diagnosis.
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