Browsing by Author "Alpaydin, AÖ"
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Item The Role of Endobronchial Biopsy in the Diagnosis of Pulmonary SarcoidosisGöktalay, T; Çelik, P; Alpaydin, AÖ; Havlucu, Y; Coskun, AS; Isisag, A; Yorgancioglu, AOBJECTIVES: This study aimed to investigate the additional diagnostic value of endobronchial biopsy (EBB) in the diagnosis of pulmonary sarcoidosis. MATERIALS AND METHODS: This retrospective cross-sectional study included 59 patients with a preliminary diagnosis of sarcoidosis who were admitted to the Pulmonary Diseases Outpatient Clinic of a tertiary healthcare center between January 2005 and October 2012. The socio-demographic characteristics of the patients as well as clinical and radiological findings were recorded. All patients, irrespective of the presence of an endobronchial lesion (EBL), underwent fiberoptic bronchoscopy (FOB); two to four specimens were taken using EBB from the carina of the right middle lobe in the patients with EBL. RESULTS: Of the patients, 39 (66.1%) had normal bronchoscopic findings, while 5 had EBL. Diagnosis was based on EBB in 11 patients (18.6%). Six patients (15.3%) with normal bronchial mucosae were pathologically diagnosed by EBB. There was no statistically significant relationship between the diagnostic ratio of EBB and disease stage, extrapulmonary involvement, FOB findings, elevated lymphocyte rate in bronchoalveolar lavage (>= 13%), a CD4/CD8 ratio of >= 3.5, and serum angiotensin-converting enzyme (ACE) level (p > 0.05). CONCLUSION: EBB not only offers the advantage of a high diagnostic ratio in patients with mucosal abnormalities but also contributes to pathological diagnosis in patients with normal mucosa. We recommend using EBB to support diagnosis with a low complication rate for patients undergoing FOB with a preliminary diagnosis of sarcoidosis in healthcare centers, where endobronchial ultrasound (EBUS) is unavailable.Item Serum and pleural fluid N-Terminal-Pro-B-Type natriuretic peptide concentrations in the differential diagnosis of pleural effusionsYorgancioglu, A; Alpaydin, AÖ; Yaman, N; Taneli, F; Bayturan, Ö; Coskun, AS; Çelik, PCurrently, new biomarkers like N-Terminal-Pro-B-Type natriuretic peptide (NT-proBNP) have been used in the differential diagnosis of pleural effusions. In our study, we aimed to investigate the diagnostic value of NT-proBNP, especially in cardiac originated pleural effusions. Forty-five patients with pleural effusions were included in the study. NT-proBNP levels and biochemical markers involved in the Light's criteria were analyzed in pleural fluid and serums of the patients. Pleural fluid culture, AFB smear, cytology were performed where they were indicated according to the clinical evaluation. In patients, to whom cardiac pathology was considered to be; cardiological evaluation and echocardiography were also done. Thirtyeight pleural effusions were exudative and, 7 were transudative according to the Light's criteria. Final diagnosis were malignant effusion in 13, infection (tuberculosis/pneumonia) in 10, congestive heart failure in 21, and other conditions related with pleural effusion in 1 of the patients. Median (25th to 75th percentiles) NT-proBNP levels of serum and pleural fluid due to congestive heart failure (CHF) were 4747 pg/mL (931-15754) and 4827 pg/mL (1290-12.430) while median NTproBNP levels of serum and pleural fluid related with non-cardiac reasons were 183 pg/mL (138-444) and 245 pg/mL (187556) respectively. NT-proBNP levels of serum and pleural fluid were significantly high in CHF (p<0.001 for both). When four groups were compared serum and pleural fluid NT-proBNP levels were highest in the CHF group which was followed by malignancy, infection and others (p<0.001 for both). Fourteen of 21 patients who were accepted to have congestive heart failure as the final diagnosis by a cardiological evaluation had an exudative pleural fluid according to the Light's criteria. Serum and pleural fluid NT-proBNP levels were higher in transudates and this reached statistically significance for pleural fluid (p= 0.009). We suggest that measurement of pleural fluid NT-proBNP is a smart approach and pleural fluid NTproBNP can reflect cardiac origin of effusions better than serum NT-proBNP and Light's criteriaItem Lower Airway Inflammation in Nonasthmatic Allergic Rhinitis PatientsAlpaydin, AÖ; Bora, M; Günhan, K; Isisag, A; Çelik, O; Çelik, P; Taneli, F; Yorgancioglu, AObjective: Allergic rhinitis and asthma have been considered as a single airway disease sharing a common pathophysiological mechanism of airway inflammation. We aimed to investigate the lower airway inflammation in allergic rhinitis patients without asthma. Material and Methods: Forty patients who referred to our tertiary care hospital's otorhinolaryngology clinic and diagnosed as moderate/severe persistent allergic rhinitis according to ARIA criteria were included in the study. After evaluation for the eligibility for the study, a nasal smear was taken, and rhinomanometry was performed to measure the nasal obstruction on visit 1. Twenty-four hours later from the visit 1, pulmonary functions including bronchial hyperactivity (BHR) were measured on visit 2. Twenty-four hours later from the visit 2, sputum induction was performed, and cell distribution of the sputums was evaluated. Results: Mean age of the 17 male and 23 female patients was 37 +/- 11. Nasal smear eosinophilia was studied in 36 of the patients and found positive in 36%. Nasal obstruction was demonstrated in 68% of the patients by rhinomanometry. BHR was positive in 30% of the participants. There was not any statistical significant relationship between nasal eosinophilia and nasal obstruction severity, BHR and induced sputum eosinophilia (p> 0.05). Among the induced sputums which were of good quality to be evaluated, 7.5% had an eosinophil ratio of 2%. Any relationship between induced sputum eosinophil percentages and FEV1, FEV1/FVC, nasal obstruction severity was not observed (p> 0.05). However, BHR was found to be significantly related with FEV1/FVC ratio which was >70% through the whole study population (r= 0.392 p= 0.012). Condusion: We could not demonstrate the expected relationship between nasal and lower airway inflammation markers in our study group of allergic rhinitis patients. This may be due to the small number of study population and strict exclusion of asthmatic patients as well as particularly the difficulties in standardization of the induced sputum technique.Item Occupational asthma in welders and paintersTemel, O; Coskun, AS; Yaman, N; Sarioglu, N; Alkaç, Ç; Konyar, I; Alpaydin, AÖ; Çelik, P; Özyurt, BC; Keskin, E; Yorgancioglu, AWe aimed to investigate the frequency of occupational asthma (OA) and the factors associated with OA development in a bicycle factory, subsequently after the diagnosis of OA in three workers at the same department. Forty one welders, 23 painters and 46 controls (office workers), a total number of 110 cases were included in the study. Turkish Thoracic Society Occupational and Environmental Diseases Evaluation Questionnaire and physical examination, chest-X ray, pulmonary function tests were performed as needed. Peak expiratory flow (PEF) follow-up was done in welders and painters. Cases having symptoms related with work and >= 20% PEF variability were diagnosed as OA. Wheezing were more frequent in welders and painters than the control group, although there wasn't a statisticall significance. Dyspnea, cough and sputum production were more frequent in welders and painters with respect to controls (p<0.05). Nine (22%) welder, 4 (18%) painter were diagnosed as OA. Working duration of welders and painters with OA (72, 156 months, respectively) were longer than the welders and painters without OA (45, 76 months, respectively), but it did not have any statistically significance. We suggest that working in welding and painting departments may cause respiratory symptoms and OA.Item Relationship of Systemic Antiinflammatory Markers and Functional Parameters in Chronic Obstructive Pulmonary DiseaseSatar, S; Alpaydin, AÖ; Var, A; Coskun, AS; Çelik, P; Yorgancioglu, AObjective: Airway inflammation and oxidative stress biomarkers increase in chronic obstructive pulmonary disease (COPD) and this is thought to be related to faster decrease in lung functions. Systemic markers of oxidative stress include nitric oxide (NO) and malonyl dialdehyde (MDA), while antioxidant markers are erythrocyte superoxide dismutase (SOD) and gluthathion-peroxidase (GSH-Px). We investigated the relationship between levels of systemic oxidative/antioxidant markers and functional parameters. Material and Method: Fifty-one COPD patients without any systemic inflammation were included in the study. Pulmonary function test parameters were evaluated. 6-minute walk test (6MWT) and dyspnea severity were recorded. Twelve healthy persons in a control group were also included in the study. Venous blood specimens of the patients and the control group were collected and serum NO, MDA and erythrocyte SOD, GSH-Px levels were measured. Results: Mean age of the patients were 62.94 +/- 10.56 years. When the control group and COPD patients were compared; MDA (p<0.001), NO (p=0.012) and GSH-Px (p=0.012) were significantly higher in the control group than COPD patients. However, when the age factor was controlled, only MDA(p=0.017) was found higher in the control group. As forced expiratory volume in 1st second (FEV 1) decreased; NO, SOD, MDA and GSH-Px increased, although there was no statistical significance. Like FEV 1, 6MWT and dyspnea severity by VAS did not show any statistical significance with the parameters investigated. Conclusion: From the results, we could not observe the reflections of oxidant/antioxidant imbalance on functional parameters in COPD. This may be due to incomplete systemic response to local disorders as well as the attempts of antioxidant systems to maintain an equilibrium resembling that in healthy individuals.Item A Lung Cancer Case With Colon MetastasisAlpaydin, AÖ; Bora, M; Nese, N; Göktan, C; Coskun, AS; Çelik, P; Yorgancioglu, ASymptomatic gastrointestinal tractus metastasis are very rare in lung cancer. We present here a case of lung cancer with colon metastasis which was evaluated as intestinal obstruction priorly.Item Smoking prevalence of elementary school students in ManisaAlkaç, C; Çelik, P; Özyurt, BC; Sakar Coskun, A; Alpaydin, AÖ; Göktalay, T; Demet, M; Yorgancioglu, AAIntroduction: In this study it is aimed to evaluate the prevalence of smoking, factors affecting smoking status, and the attitudes of the elementary school students towards the smoking prohibition law which was approved in July 2009, in city. Materials and Methods: The universe of this descriptive study was 6th -7th -8th class, 8236 urban and 4937 semi-urban, total 13.173 elementary schools students in city center. Study population was determined on the basis of a previous study in which the smoking trial prevalence was found 17.5%, 831 students in 6 urban 3 semi-urban, total 9 schools were chosen randomly. A questionnaire was prepared investigating smoking status, the effects of smoking and family history. Among the 9 chosen schools, the questionnaire was applied to 615 students. SPSS 14.0 statistical package was used. Results: Forty-seven percentages of the students were female. Prevalence of smoking trial was found 23.5% (16% in urban, 35% in semi-urban schools) while the prevalence of smoking was 7.1% (1.7% in urban, 15.7% in semi-urban schools). Mean age of first smoking trial was 10.04 +/- 2.3. The smoking prohibition law was supported by 86.6% of the students, the warnings on the cigarette package was thought to be effective by 43.3% students and 35.2% of the students were exposed to passive smoke. Male gender, social status, education level of the family, smoker family member or close friends were found to be important risk factors for smoking prevalence of the students. Conclusion: The early onset of smoking should guide the smoking struggle be concentrated in elementary school especially in semi-urban areas where the smoking prevalence is high.Item Toll-Like Receptor 2 Expression and Peripheral Blood CD4+/CD8+ T Cell Ratio in COPDUlutas, GS; Alpaydin, AÖ; Taneli, F; Çetinkaya, C; Ulman, C; Güvenç, Y; Horasan, GD; Coskun, ASOBJECTIVES : We aimed to evaluate toll- like receptor 2 (TLR- 2) expression on monocytes and peripheral blood CD4+/CD8+ T cell ratio, as well as the relationship of these cells with pulmonary functions in chronic obstructive pulmonary disease (COPD) patients. MATERIAL AND METHODS : Forty COPD patients and 40 healthy volunteers were included. Participants were analysed in four groups according to their smoking status. Peripheral blood CD4+ and CD8+ T cells and monocyte TLR- 2 expression were measured by flow cytometry in the whole study population. RESULTS : No significant difference was observed in TLR- 2 expression, number of CD4+ and CD8+ T cells, and CD4+/CD8+ T cell ratio between the study groups. CD4+/CD8+ T cell ratio and FEV 1 /FVC were found to have a mild positive correlation (r= 0.295, p= 0.022). A mild negative correlation was observed between smoking intensity and CD4+/CD8+ T cell ratio (r=- 0.274, p= 0.034). CONCLUSION : We demonstrated a mild correlation between pulmonary functions and peripheral blood CD4+/CD8+ T cell ratio. However, we did not find a significant difference in TLR- 2 expression of CD14+ monocytes in patients with airway obstruction.