Body: Aim: Thoracenthesis is the first investigation to be done in a lung cancer patient with ple... more Body: Aim: Thoracenthesis is the first investigation to be done in a lung cancer patient with pleural effusion. We routinely use conventional smear studies (CSS) for diagnosis. We aimed to investigate the diagnostic utility of cell block (CB) method combined with CSS in the first thoracentesis. Method: Forty lung cancer patients with exudative pleural effusions were included in this study. 10 ml of fresh pleural fluid sample was received from all patients in the initial evaluation. Pleural fluid sample was divided into two equal parts. One part was subjected to CSS and the other to CB method. Conventional smears were stained with Giemsa stain and Hematoxylin-Eosin (HE). CB sections were stained with HE and mucicarmine. CSS findings were grouped as "benign cytology" or "malignant cytology". The "suspicion of malignancy" was grouped in the "benign cytology" group. The CB sections were evaluated for the presence of single tumor cell, acinary, papillary pattern, solid islands and staining with mucicarmine. Results: There were 20 patients each in benign and malignant CSS group. In benign CSS group, adding CB method to CSS provided a diagnosis of malignancy in 4 more patients and the diagnosis of malignant effusion was increased by a ratio of (4/40) 10%. In malignant CSS group, adding CB technique provided the subtyping of lung cancer as adenocarcinoma in 7 patients (7/20, 35%). Conclusion: Our study confirms the diagnostic utility of CB method combined with CSS. Therefore we recommend routine performing CB method combined with CSS in the first thoracentesis in a lung cancer patient with pleural effusion.
Bronchogenic cysts are congenital malformations thought to originate from the primitive ventral f... more Bronchogenic cysts are congenital malformations thought to originate from the primitive ventral foregut, and they are the most common type of mediastinal cystic lesion. The clinical presentation of a bronchogenic cyst is variable, from respiratory distress at birth to late appearance of symptoms. Most bronchogenic cysts originate in the mediastinum, and 15% to 20% occur in the lung parenchyma. Various malignant transformations have been reported in the literature. In this report, we describe a case of schwannoma in an intrapulmonary bronchogenic cyst wall in a 38-year-old man, which was found incidentally during a routine examination.
Goals: We aimed to determine the role of thorax high-resolution computed tomography (HRCT) in dem... more Goals: We aimed to determine the role of thorax high-resolution computed tomography (HRCT) in demonstrating the pulmonary vasodilatation in patients with hepatopulmonary syndrome (HPS). Background: Traditionally, the presence of intrapulmonary vascular dilatations can be detected by using one of the three diagnostic modalities: contrast-enhanced echocardiography, technetium 99 mlabeled macroaggregated albumin scan, and pulmonary angiography. Study: The study group included 10 patients with HPS (Group 1), 12 patients with normoxemic cirrhosis (Group 2), and 12 healthy controls (Group 3). All of the subjects underwent conventional and HRCT of thorax. The diameters of pulmonary trunk, main pulmonary arteries, and right lower lobe basal segmental arteries were measured. The ratios of right lower lobe basal segmental pulmonary artery to bronchus diameter were calculated. Results: The mean diameters of the main pulmonary trunk, right and left main pulmonary arteries were not different between the groups. Mean diameters of right lower lobe basal segmental pulmonary arteries were significantly higher in Group 1 compared with Group 2 (P = 0.01) and Group 3 (P = 0.002). Mean right lower lobe basal segmental pulmonary artery to bronchus ratios were significantly higher in Group 1 compared with Group 2 (P = 0.03) and Group 3 (P , 0.001). Group 2 had significantly higher pulmonary artery to bronchus ratios than Group 3 (P , 0.001). Conclusions: Thorax HRCT may be helpful in the diagnosis of HPS by demonstrating the dilated peripheral pulmonary vessels or increased pulmonary artery to bronchus ratios in patients with liver disease and hypoxemia.
Background: We aimed to investigate the correlation of maximum standardized uptake value (SUVmax)... more Background: We aimed to investigate the correlation of maximum standardized uptake value (SUVmax) with pathological characteristics of primary tumor and to determine a Tumor/ Lymph node (T/LN) SUVmax ratio predicting metastasis to lymph nodes in NSCLC patients. Methods: Eighty-one NSCLC patients who had PET/CT examination at initial staging and subsequently underwent surgical resection were retrospectively evaluated. There were 100 PET/CT positive mediastinal or hilar lymph node stations. Pathological characteristics of the tumor such as largest tumor diameter, tumor histology, differentiation, number of mitosis, degree of stromal inflammation, necrosis; etiology of PET/CT positive lymph node stations; SUVmax of primary tumor and positive lymph node stations were recorded. A T/LN SUVmax ratio was calculated for each lymph node station. Results: SUVmax of the primary tumor was positively correlated with the largest tumor diameter (p = 0.001, r = 0.374), number of mitosis (p < 0.001, r = 0.405), and postoperative pathological stage (p = 0.007, r = 0.298). Patients with squamous cell carcinoma had a statistically significant higher mean SUVmax, number of mitosis and advanced N stages compared to adenocarcinoma. The etiology of 100 PET/CT positive lymph node stations were metastasis in 14, anthracosis in 40, reactive in 39, granulomatous in 4, and silicosis in 3 patients. A T/LN SUVmax ratio of 5 or lower was suggestive for a malignant lymph node with a sensitivity of 92.8% and specificity of 47%. Conclusions: SUVmax of a primary tumor is related to certain pathological characteristics, such as largest diameter, histology, and number of mitosis. A T/LN SUVmax ratio lower than 5 predicts the metastasis to lymph nodes with a high sensitivity.
Aims and Background: Survivin is a recently identified protein as an inhibitor of apoptosis, whic... more Aims and Background: Survivin is a recently identified protein as an inhibitor of apoptosis, which supresses programmed cell death and regulates cell division. In this study, we investigated the prognostic significance of both nuclear and cytoplasmic survivin expression in non-small cell lung cancer (NSCLC) and examined the association with clinicopathological parameters. Methods: The study comprised 58 male patients diagnosed NSCLC with a mean age of 57.2978.82 years; range 40-76 years. Patients underwent lobectomy (64%) or pneumonectomy (36%) with hilar and mediastinal lymph node sampling. Paraffin embedded tumor sections were retrieved for evaluation of nuclear and cytoplasmic staining of survivin. Clinicopathological data, stage and survival of patients were all determined. Results: Cytoplasmic staining was found significantly increased in squamous cell carcinoma (P ¼ 0:003), whereas there was no association between nuclear staining and histopathological type (P ¼ 0:837). Also, both nuclear and cytoplasmic staining did not show any association with tumor stage (P40:05). In univariate analysis there was significant correlation between nuclear survivin and short survival (P ¼ 0:0002). In multivariate survival analysis using Cox regression, only nuclear staining of survivin was determined as an independent prognostic factor (P ¼ 0:004). Conclusions: Localization of survivin expression might have an important regulatory mechanism in carcinogenesis and tumor progression. Nuclear survivin expression in
Topoisomerase 2α (Topo 2α) is a nuclear enzyme that alters the topology of DNA. It's essentia... more Topoisomerase 2α (Topo 2α) is a nuclear enzyme that alters the topology of DNA. It's essential for normal chromosome segregation during cellular division. We aimed to investigate the association of Topo 2α expression with clinical, pathological parameters and prognosis in surgically resected non-small cell lung cancer (NSCLC) patients. The study is comprised of 100 surgically resected NSCLC (squamous cell carcinoma in 50 patients, adenocarcinoma in 50 patients). The paraffin embedded tumor sections were retrieved for expression of Topo 2α. Nuclear and cytoplasmic expression of Topo 2α was determined by immunohistochemistry. Clinical, pathological data and survival of patients were determined from the hospital files. Median follow-up time was 35 (range, 4-120) months. Nuclear and cytoplasmic expression of Topo 2α was positive in 41 (41%) and 66 (66%) patients, respectively. There was no significant association between nuclear or cytoplasmic expression of Topo 2α and age, gender, ...
Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reac... more Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reaction in the mediastinum which can result in compromise of airways, great vessels, and other mediastinal structures. In this paper we presented a patient with fibrosing mediastinitis mimicking bronchogenic carcinoma. The patient was a 32-year-old diabetic male admitting with cough and hemoptysis. There was a right hilar mass and multiple mediastinal conglomerated lymph nodes on chest computed tomography. Positron emission tomography with computed tomography (PET/CT) scan demonstrated increased fluorodeoxyglucose (FDG) uptake at the right hilar mass lesion and mediastinal lymph nodes. Fiberoptic bronchoscopy showed mucosal distortion of right upper lobe. Pathologic examination of the mucosal biopsy revealed inflammation. Endobronchial ultrasound guided transbronchial needle and cervical mediastinoscopic lymph node biopsies were undiagnostic. Diagnostic thoracotomy confirmed the diagnosis f...
Interferon (IFN)-gamma plays a pivotal role in protective immunity against Mycobacterium tubercul... more Interferon (IFN)-gamma plays a pivotal role in protective immunity against Mycobacterium tuberculosis. Elevations of IFN-gamma have been found in the affected lung and bloodstream of patients with pulmonary tuberculosis. In the present study, we aimed to investigate the role of serum IFN-gamma level in the differential diagnosis of active and inactive pulmonary tuberculosis. Fourty seven patients with newly diagnosed active pulmonary tuberculosis, 21 patients with inactive pulmonary tuberculosis, and 20 healthy volunteers were enrolled in the study. Serum samples were collected from each subject and stored at - 70 degrees C until the analysis of IFN-gamma. The mean value of IFN-gamma levels were 9.3 +/- 4.6 pg/mL in patients with newly diagnosed pulmonary tuberculosis, 9.8 +/- 3.8 pg/mL in patients with inactive tuberculosis, and 10.2 +/- 3.4 pg/mL in healthy controls. The comparison of IFN-gamma levels of the three groups was not found statistically significant (p= 0.4). Serum IFN-...
2020 28th Signal Processing and Communications Applications Conference (SIU)
In the diagnosis of chest diseases, the success of classification with computerized decision assi... more In the diagnosis of chest diseases, the success of classification with computerized decision assistance systems during auscultation and diagnosis by the specialist is increasing day by day. In this study, 100 respiratory sounds (50 normal and 50 abnormal) sampled at 4kHz, collected by electronic stethoscope for 15 seconds in accordance with routine clinical protocols, were used and no further patient data were used. These sounds were classified by using Support Vector Machines (SVM) and Convolutional Neural Networks (CNN) methods by applying normalization, spectrogram image with STFT, preprocessing such as MFCC and extraction of spectral features. The training set was determined as 80 and the test set as 20, and the success of classification after the study was 67% and 80%, respectively. It has been shown that CNN yields better results than SVM with clinical data with a success rate of 80% and also can be used to classify Ral and Rhonchi from pathological sounds and the highest success rate has been demonstrated by the use of the three layers CNN architecture.
OBJECTIVE: Early diagnosis and treatment of lung cancer is very important for the prognosis of th... more OBJECTIVE: Early diagnosis and treatment of lung cancer is very important for the prognosis of the patients with lung cancer. This study was undertaken to investigate patient delay and doctor delay in the diagnosis and the treatment of non-small cell lung cancer. In addition, the factors effect of these delays was researched. MATERIAL and METHOD: Between May 2010-May 2011 years, mean age 61.5±10.1, 1016 patients were enrolled prospectively in this study from the different countries in Turkey. 926 (91.1%) of the patients were male and 90 (8.9%) were female. RESULTS: Patient delay was found 49.96±96.96 days, doctor delay was found 87.71±99.59 days and total delay was found 131.3±135.18 days. Referral delay was found 61.55±127.23 days, diagnostic delay was found 20.35±44.46 days and treatment delay was found 24.37±54.97 days. Patient delay was more frequently in the workers but referral delay was more frequent in patients living in the village (p<0.05). We determined that referral d...
Chest physicians frequently come across with the symptom hemoptysis, an alerting symptom which ma... more Chest physicians frequently come across with the symptom hemoptysis, an alerting symptom which may result from a wide variety of disorders. In this study, we aimed to determine the main causes of hemoptysis in a reference hospital for chest diseases. All the patients who admitted to our emergency clinic with hemoptysis during three months of study period were included in the study. The mean age of 143 patients (106 males, 37 females) who were included in this study was 48 +/- 17 years. Medical history, physical examination and chest radiography were performed for each patient. Sputum examination for acid fast bacilli, computed tomography of thorax, fiberoptic bronchoscopy, ventilation-perfusion scintigraphy, echocardiography, ear-nose-throat examination and upper gastrointestinal system endoscopy were the further diagnostic investigations for selected patients. Bronchiectasis was the most common cause of hemoptysis (22.4%), followed by lung cancer (18.9%), active tuberculosis (11.2%...
... Henüz hiçbir tümör belirtisi olmayan bir olgu tromboz nedeniyle araştırıldığında kanser tanıs... more ... Henüz hiçbir tümör belirtisi olmayan bir olgu tromboz nedeniyle araştırıldığında kanser tanısı alabilmektedir (9,10). Önceye ait kanser öyküsü olmayan, DVT veya PTE olan olguların, yaklaşık %5'i bir yıl içinde kanser tanısı almaktadır (11). ...
A 58-year-old male patient presented with widespread psoriatic plaques with a Psoriasis Area and ... more A 58-year-old male patient presented with widespread psoriatic plaques with a Psoriasis Area and Severity Index of 22.6. Due to the lack of benefit from multiple topical agents and methotrexate, he was a candidate for biological therapy. Routine investigations including initial chest radiography and laboratory tests were normal prior to the initiation of therapy. He had no history of lung disease and no contact with tuberculosis patients. Isoniazid prophylaxis was initiated one month prior to adalimumab therapy owing to QuantiFERON®-TB Gold test (Cellestis Limited, Carnegie, Victoria, Australia) positivity. At the end of one month of isoniazid prophylaxis therapy, adalimumab was initiated and the patient received adalimumab for four years without any side effects. Detailed anamnesis revealed that the patient was working as a farmer and plowing fields, and he stated that during the summer, the weather was dry, windy, and dusty in the region he lived.
Introduction and Aim: Paradoxical r eactions (PR) are immune-mediated exacerbations of tuberculos... more Introduction and Aim: Paradoxical r eactions (PR) are immune-mediated exacerbations of tuberculosis triggered by therapy. We aimed to investigate the incidence and sort of PR among HIV(-) pulmonary tuberculosis patients in a one year period. Material and Method: During a one year peiod, we prospectively evaluate all pulmonary tuberculosis patients hospitalised in our clinic for the development of PR. We excluded chronic or failure c ases from this study and evaluate 205 patients. Results: PR occurred in 5 (2.4%) patients. Two patients presented with new paranchymal infiltrations, 2 with new pleural effusion, and 1 with increase of previous pleural effusion. Conclusion: PR are not so infrequent during treatment course of HIV (-) pulmonary tuberculosis. It is extremely important to recognize this benign and self limited clinical entity i n order to avoid unnecessary invasive procedures or changing of an appropriate therapy.
Introduction Bronchoscopic biopsies and bronchial washings (BW) are commonly used together for th... more Introduction Bronchoscopic biopsies and bronchial washings (BW) are commonly used together for the diagnosis of centrally located tumors. This study aimed to investigate the clinical relevance of routinely collecting BWs in patients who simultaneously had biopsies for visible endobronchial lesions in the current molecular analysis-driven personalized medicine era. Materials and Methods We retrospectively reviewed the patients who underwent fiberoptic bronchoscopy (FOB) between October 2011 and December 2016. Patients who had both BW and biopsy specimens (EBB: endobronchial forceps biopsy and/or EBNA: endobronchial needle aspiration biopsy) for visible endobronchial lesions were included in this study. Demographic and clinical data, macroscopic findings during FOB, pathology results, and final diagnoses were collected from the hospital database. Result The study included 269 patients (220 males/49 females) with a mean age of 61.6 ± 10.6 years. While the overall diagnostic yield of FOB was 71.4%, the diagnostic yields of bronchoscopic procedures were 68.2% for EBB, 83.3% for EBNA, and 19.7% for BW. Only three patients (1.1%) with undiagnostic biopsies had positive BW cytology revealing merely malignant epithelial cells. Conclusions BW provided a negligible diagnostic contribution in 1.1% (n= 3) of the patients. These three patients had undergone further diagnostic procedures for making a proper therapeutic management plan. In the era of personalized therapy, it is logical to obtain more biopsy in the time spent for BWs.
Body: Aim: Thoracenthesis is the first investigation to be done in a lung cancer patient with ple... more Body: Aim: Thoracenthesis is the first investigation to be done in a lung cancer patient with pleural effusion. We routinely use conventional smear studies (CSS) for diagnosis. We aimed to investigate the diagnostic utility of cell block (CB) method combined with CSS in the first thoracentesis. Method: Forty lung cancer patients with exudative pleural effusions were included in this study. 10 ml of fresh pleural fluid sample was received from all patients in the initial evaluation. Pleural fluid sample was divided into two equal parts. One part was subjected to CSS and the other to CB method. Conventional smears were stained with Giemsa stain and Hematoxylin-Eosin (HE). CB sections were stained with HE and mucicarmine. CSS findings were grouped as "benign cytology" or "malignant cytology". The "suspicion of malignancy" was grouped in the "benign cytology" group. The CB sections were evaluated for the presence of single tumor cell, acinary, papillary pattern, solid islands and staining with mucicarmine. Results: There were 20 patients each in benign and malignant CSS group. In benign CSS group, adding CB method to CSS provided a diagnosis of malignancy in 4 more patients and the diagnosis of malignant effusion was increased by a ratio of (4/40) 10%. In malignant CSS group, adding CB technique provided the subtyping of lung cancer as adenocarcinoma in 7 patients (7/20, 35%). Conclusion: Our study confirms the diagnostic utility of CB method combined with CSS. Therefore we recommend routine performing CB method combined with CSS in the first thoracentesis in a lung cancer patient with pleural effusion.
Bronchogenic cysts are congenital malformations thought to originate from the primitive ventral f... more Bronchogenic cysts are congenital malformations thought to originate from the primitive ventral foregut, and they are the most common type of mediastinal cystic lesion. The clinical presentation of a bronchogenic cyst is variable, from respiratory distress at birth to late appearance of symptoms. Most bronchogenic cysts originate in the mediastinum, and 15% to 20% occur in the lung parenchyma. Various malignant transformations have been reported in the literature. In this report, we describe a case of schwannoma in an intrapulmonary bronchogenic cyst wall in a 38-year-old man, which was found incidentally during a routine examination.
Goals: We aimed to determine the role of thorax high-resolution computed tomography (HRCT) in dem... more Goals: We aimed to determine the role of thorax high-resolution computed tomography (HRCT) in demonstrating the pulmonary vasodilatation in patients with hepatopulmonary syndrome (HPS). Background: Traditionally, the presence of intrapulmonary vascular dilatations can be detected by using one of the three diagnostic modalities: contrast-enhanced echocardiography, technetium 99 mlabeled macroaggregated albumin scan, and pulmonary angiography. Study: The study group included 10 patients with HPS (Group 1), 12 patients with normoxemic cirrhosis (Group 2), and 12 healthy controls (Group 3). All of the subjects underwent conventional and HRCT of thorax. The diameters of pulmonary trunk, main pulmonary arteries, and right lower lobe basal segmental arteries were measured. The ratios of right lower lobe basal segmental pulmonary artery to bronchus diameter were calculated. Results: The mean diameters of the main pulmonary trunk, right and left main pulmonary arteries were not different between the groups. Mean diameters of right lower lobe basal segmental pulmonary arteries were significantly higher in Group 1 compared with Group 2 (P = 0.01) and Group 3 (P = 0.002). Mean right lower lobe basal segmental pulmonary artery to bronchus ratios were significantly higher in Group 1 compared with Group 2 (P = 0.03) and Group 3 (P , 0.001). Group 2 had significantly higher pulmonary artery to bronchus ratios than Group 3 (P , 0.001). Conclusions: Thorax HRCT may be helpful in the diagnosis of HPS by demonstrating the dilated peripheral pulmonary vessels or increased pulmonary artery to bronchus ratios in patients with liver disease and hypoxemia.
Background: We aimed to investigate the correlation of maximum standardized uptake value (SUVmax)... more Background: We aimed to investigate the correlation of maximum standardized uptake value (SUVmax) with pathological characteristics of primary tumor and to determine a Tumor/ Lymph node (T/LN) SUVmax ratio predicting metastasis to lymph nodes in NSCLC patients. Methods: Eighty-one NSCLC patients who had PET/CT examination at initial staging and subsequently underwent surgical resection were retrospectively evaluated. There were 100 PET/CT positive mediastinal or hilar lymph node stations. Pathological characteristics of the tumor such as largest tumor diameter, tumor histology, differentiation, number of mitosis, degree of stromal inflammation, necrosis; etiology of PET/CT positive lymph node stations; SUVmax of primary tumor and positive lymph node stations were recorded. A T/LN SUVmax ratio was calculated for each lymph node station. Results: SUVmax of the primary tumor was positively correlated with the largest tumor diameter (p = 0.001, r = 0.374), number of mitosis (p < 0.001, r = 0.405), and postoperative pathological stage (p = 0.007, r = 0.298). Patients with squamous cell carcinoma had a statistically significant higher mean SUVmax, number of mitosis and advanced N stages compared to adenocarcinoma. The etiology of 100 PET/CT positive lymph node stations were metastasis in 14, anthracosis in 40, reactive in 39, granulomatous in 4, and silicosis in 3 patients. A T/LN SUVmax ratio of 5 or lower was suggestive for a malignant lymph node with a sensitivity of 92.8% and specificity of 47%. Conclusions: SUVmax of a primary tumor is related to certain pathological characteristics, such as largest diameter, histology, and number of mitosis. A T/LN SUVmax ratio lower than 5 predicts the metastasis to lymph nodes with a high sensitivity.
Aims and Background: Survivin is a recently identified protein as an inhibitor of apoptosis, whic... more Aims and Background: Survivin is a recently identified protein as an inhibitor of apoptosis, which supresses programmed cell death and regulates cell division. In this study, we investigated the prognostic significance of both nuclear and cytoplasmic survivin expression in non-small cell lung cancer (NSCLC) and examined the association with clinicopathological parameters. Methods: The study comprised 58 male patients diagnosed NSCLC with a mean age of 57.2978.82 years; range 40-76 years. Patients underwent lobectomy (64%) or pneumonectomy (36%) with hilar and mediastinal lymph node sampling. Paraffin embedded tumor sections were retrieved for evaluation of nuclear and cytoplasmic staining of survivin. Clinicopathological data, stage and survival of patients were all determined. Results: Cytoplasmic staining was found significantly increased in squamous cell carcinoma (P ¼ 0:003), whereas there was no association between nuclear staining and histopathological type (P ¼ 0:837). Also, both nuclear and cytoplasmic staining did not show any association with tumor stage (P40:05). In univariate analysis there was significant correlation between nuclear survivin and short survival (P ¼ 0:0002). In multivariate survival analysis using Cox regression, only nuclear staining of survivin was determined as an independent prognostic factor (P ¼ 0:004). Conclusions: Localization of survivin expression might have an important regulatory mechanism in carcinogenesis and tumor progression. Nuclear survivin expression in
Topoisomerase 2α (Topo 2α) is a nuclear enzyme that alters the topology of DNA. It's essentia... more Topoisomerase 2α (Topo 2α) is a nuclear enzyme that alters the topology of DNA. It's essential for normal chromosome segregation during cellular division. We aimed to investigate the association of Topo 2α expression with clinical, pathological parameters and prognosis in surgically resected non-small cell lung cancer (NSCLC) patients. The study is comprised of 100 surgically resected NSCLC (squamous cell carcinoma in 50 patients, adenocarcinoma in 50 patients). The paraffin embedded tumor sections were retrieved for expression of Topo 2α. Nuclear and cytoplasmic expression of Topo 2α was determined by immunohistochemistry. Clinical, pathological data and survival of patients were determined from the hospital files. Median follow-up time was 35 (range, 4-120) months. Nuclear and cytoplasmic expression of Topo 2α was positive in 41 (41%) and 66 (66%) patients, respectively. There was no significant association between nuclear or cytoplasmic expression of Topo 2α and age, gender, ...
Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reac... more Fibrosing mediastinitis is a rare but benign disorder characterized by an excessive fibrotic reaction in the mediastinum which can result in compromise of airways, great vessels, and other mediastinal structures. In this paper we presented a patient with fibrosing mediastinitis mimicking bronchogenic carcinoma. The patient was a 32-year-old diabetic male admitting with cough and hemoptysis. There was a right hilar mass and multiple mediastinal conglomerated lymph nodes on chest computed tomography. Positron emission tomography with computed tomography (PET/CT) scan demonstrated increased fluorodeoxyglucose (FDG) uptake at the right hilar mass lesion and mediastinal lymph nodes. Fiberoptic bronchoscopy showed mucosal distortion of right upper lobe. Pathologic examination of the mucosal biopsy revealed inflammation. Endobronchial ultrasound guided transbronchial needle and cervical mediastinoscopic lymph node biopsies were undiagnostic. Diagnostic thoracotomy confirmed the diagnosis f...
Interferon (IFN)-gamma plays a pivotal role in protective immunity against Mycobacterium tubercul... more Interferon (IFN)-gamma plays a pivotal role in protective immunity against Mycobacterium tuberculosis. Elevations of IFN-gamma have been found in the affected lung and bloodstream of patients with pulmonary tuberculosis. In the present study, we aimed to investigate the role of serum IFN-gamma level in the differential diagnosis of active and inactive pulmonary tuberculosis. Fourty seven patients with newly diagnosed active pulmonary tuberculosis, 21 patients with inactive pulmonary tuberculosis, and 20 healthy volunteers were enrolled in the study. Serum samples were collected from each subject and stored at - 70 degrees C until the analysis of IFN-gamma. The mean value of IFN-gamma levels were 9.3 +/- 4.6 pg/mL in patients with newly diagnosed pulmonary tuberculosis, 9.8 +/- 3.8 pg/mL in patients with inactive tuberculosis, and 10.2 +/- 3.4 pg/mL in healthy controls. The comparison of IFN-gamma levels of the three groups was not found statistically significant (p= 0.4). Serum IFN-...
2020 28th Signal Processing and Communications Applications Conference (SIU)
In the diagnosis of chest diseases, the success of classification with computerized decision assi... more In the diagnosis of chest diseases, the success of classification with computerized decision assistance systems during auscultation and diagnosis by the specialist is increasing day by day. In this study, 100 respiratory sounds (50 normal and 50 abnormal) sampled at 4kHz, collected by electronic stethoscope for 15 seconds in accordance with routine clinical protocols, were used and no further patient data were used. These sounds were classified by using Support Vector Machines (SVM) and Convolutional Neural Networks (CNN) methods by applying normalization, spectrogram image with STFT, preprocessing such as MFCC and extraction of spectral features. The training set was determined as 80 and the test set as 20, and the success of classification after the study was 67% and 80%, respectively. It has been shown that CNN yields better results than SVM with clinical data with a success rate of 80% and also can be used to classify Ral and Rhonchi from pathological sounds and the highest success rate has been demonstrated by the use of the three layers CNN architecture.
OBJECTIVE: Early diagnosis and treatment of lung cancer is very important for the prognosis of th... more OBJECTIVE: Early diagnosis and treatment of lung cancer is very important for the prognosis of the patients with lung cancer. This study was undertaken to investigate patient delay and doctor delay in the diagnosis and the treatment of non-small cell lung cancer. In addition, the factors effect of these delays was researched. MATERIAL and METHOD: Between May 2010-May 2011 years, mean age 61.5±10.1, 1016 patients were enrolled prospectively in this study from the different countries in Turkey. 926 (91.1%) of the patients were male and 90 (8.9%) were female. RESULTS: Patient delay was found 49.96±96.96 days, doctor delay was found 87.71±99.59 days and total delay was found 131.3±135.18 days. Referral delay was found 61.55±127.23 days, diagnostic delay was found 20.35±44.46 days and treatment delay was found 24.37±54.97 days. Patient delay was more frequently in the workers but referral delay was more frequent in patients living in the village (p<0.05). We determined that referral d...
Chest physicians frequently come across with the symptom hemoptysis, an alerting symptom which ma... more Chest physicians frequently come across with the symptom hemoptysis, an alerting symptom which may result from a wide variety of disorders. In this study, we aimed to determine the main causes of hemoptysis in a reference hospital for chest diseases. All the patients who admitted to our emergency clinic with hemoptysis during three months of study period were included in the study. The mean age of 143 patients (106 males, 37 females) who were included in this study was 48 +/- 17 years. Medical history, physical examination and chest radiography were performed for each patient. Sputum examination for acid fast bacilli, computed tomography of thorax, fiberoptic bronchoscopy, ventilation-perfusion scintigraphy, echocardiography, ear-nose-throat examination and upper gastrointestinal system endoscopy were the further diagnostic investigations for selected patients. Bronchiectasis was the most common cause of hemoptysis (22.4%), followed by lung cancer (18.9%), active tuberculosis (11.2%...
... Henüz hiçbir tümör belirtisi olmayan bir olgu tromboz nedeniyle araştırıldığında kanser tanıs... more ... Henüz hiçbir tümör belirtisi olmayan bir olgu tromboz nedeniyle araştırıldığında kanser tanısı alabilmektedir (9,10). Önceye ait kanser öyküsü olmayan, DVT veya PTE olan olguların, yaklaşık %5'i bir yıl içinde kanser tanısı almaktadır (11). ...
A 58-year-old male patient presented with widespread psoriatic plaques with a Psoriasis Area and ... more A 58-year-old male patient presented with widespread psoriatic plaques with a Psoriasis Area and Severity Index of 22.6. Due to the lack of benefit from multiple topical agents and methotrexate, he was a candidate for biological therapy. Routine investigations including initial chest radiography and laboratory tests were normal prior to the initiation of therapy. He had no history of lung disease and no contact with tuberculosis patients. Isoniazid prophylaxis was initiated one month prior to adalimumab therapy owing to QuantiFERON®-TB Gold test (Cellestis Limited, Carnegie, Victoria, Australia) positivity. At the end of one month of isoniazid prophylaxis therapy, adalimumab was initiated and the patient received adalimumab for four years without any side effects. Detailed anamnesis revealed that the patient was working as a farmer and plowing fields, and he stated that during the summer, the weather was dry, windy, and dusty in the region he lived.
Introduction and Aim: Paradoxical r eactions (PR) are immune-mediated exacerbations of tuberculos... more Introduction and Aim: Paradoxical r eactions (PR) are immune-mediated exacerbations of tuberculosis triggered by therapy. We aimed to investigate the incidence and sort of PR among HIV(-) pulmonary tuberculosis patients in a one year period. Material and Method: During a one year peiod, we prospectively evaluate all pulmonary tuberculosis patients hospitalised in our clinic for the development of PR. We excluded chronic or failure c ases from this study and evaluate 205 patients. Results: PR occurred in 5 (2.4%) patients. Two patients presented with new paranchymal infiltrations, 2 with new pleural effusion, and 1 with increase of previous pleural effusion. Conclusion: PR are not so infrequent during treatment course of HIV (-) pulmonary tuberculosis. It is extremely important to recognize this benign and self limited clinical entity i n order to avoid unnecessary invasive procedures or changing of an appropriate therapy.
Introduction Bronchoscopic biopsies and bronchial washings (BW) are commonly used together for th... more Introduction Bronchoscopic biopsies and bronchial washings (BW) are commonly used together for the diagnosis of centrally located tumors. This study aimed to investigate the clinical relevance of routinely collecting BWs in patients who simultaneously had biopsies for visible endobronchial lesions in the current molecular analysis-driven personalized medicine era. Materials and Methods We retrospectively reviewed the patients who underwent fiberoptic bronchoscopy (FOB) between October 2011 and December 2016. Patients who had both BW and biopsy specimens (EBB: endobronchial forceps biopsy and/or EBNA: endobronchial needle aspiration biopsy) for visible endobronchial lesions were included in this study. Demographic and clinical data, macroscopic findings during FOB, pathology results, and final diagnoses were collected from the hospital database. Result The study included 269 patients (220 males/49 females) with a mean age of 61.6 ± 10.6 years. While the overall diagnostic yield of FOB was 71.4%, the diagnostic yields of bronchoscopic procedures were 68.2% for EBB, 83.3% for EBNA, and 19.7% for BW. Only three patients (1.1%) with undiagnostic biopsies had positive BW cytology revealing merely malignant epithelial cells. Conclusions BW provided a negligible diagnostic contribution in 1.1% (n= 3) of the patients. These three patients had undergone further diagnostic procedures for making a proper therapeutic management plan. In the era of personalized therapy, it is logical to obtain more biopsy in the time spent for BWs.
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Papers by Deniz Köksal