Thoracic Surgery Training and Research Hospital

İstanbul, Turkey

Thoracic Surgery Training and Research Hospital

İstanbul, Turkey

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Babalik A.,Thoracic Surgery Training and Research Hospital | Ulus I.H.,Acibadem University | Bakirci N.,Acibadem University | Kuyucu T.,Thoracic Surgery Training and Research Hospital | And 3 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2013

Plasma isoniazid and rifampin concentrations, but not pyrazinamide and ethambutol concentrations, were decreased by about 50% (P<0.05) in diabetic pulmonary tuberculosis patients. The prevalences of subnormal plasma isoniazid, rifampin, pyrazinamide, and ethambutol concentrations were 49% or 100% (P<0.01), 66% or 100% (P<0.05), 30% or 50% (P=0.198), and 32% or 21% (P=0.742) in nondiabetic or diabetic tuberculosis patients, respectively. These data show that plasma concentrations of isoniazid and rifampin were greatly reduced in diabetic tuberculosis patients. Copyright © 2013, American Society for Microbiology. All Rights Reserved.


Guven S.F.,Sleep Disorders Center | Guven S.F.,Baskent University | Ciftci B.,Sleep Disorders Center | Ciftci B.,Baskent University | And 4 more authors.
Saudi Medical Journal | Year: 2013

Objectives: To define the frequency of supine positional obstructive sleep apnea (OSA) in patients diagnosed with OSA and to describe the demographic associations with positional OSA (PO). Methods: A retrospective study was performed in a total of 3813 patients who underwent full-night polysomnography at the Sleep Disorders Center of the Atatürk Chest Diseases, Thoracic Surgery Education and Research Hospital, Ankara, Turkey between June 2007 and June 2010. A total of 3214 patients diagnosed with OSA were included in the study. Positional OSA was defined as a total AHI ≥5, and supine AHI/non-supine AHI ≥2. Characteristics of positional OSA and non-positional OSA groups were compared statistically. Results: Patients classified as positional OSA composed 39.9% of all OSA patients. Positional OSA patients were younger with lower body mass index and their OSA was less severe. Conclusion: Positional OSA, which may require different treatment approaches, is not uncommon among OSA patients and should be understood as a different clinical entity.


Mete T.,Ankara Numune Training and Research Hospital | Yalcin Y.,Ankara Numune Training and Research Hospital | Berker D.,Ankara Numune Training and Research Hospital | Ciftci B.,Thoracic Surgery Training and Research Hospital | And 4 more authors.
Endocrine | Year: 2013

Obstructive sleep apnea syndrome (OSAS) is a widespread disorder characterized by recurrent, partial, or complete episodes of apnea due to upper airway tract obstruction during sleep. OSAS frequency is likely to increase in hypothyroidism because of obesity, macroglossia, dysfunctional upper respiratory tractus (URT) musculature, deposition of mucopolysaccharides in URT tissues, and decreased ventilatory control. This study examines the relationship between OSAS and thyroid disease in OSAS subjects. This study includes 150 polysomnographically diagnosed OSAS patients (50 mild, 50 moderate, 50 severe OSAS cases) treated at Endocrinology and Metabolism Department of Ankara Numune Training and Research Hospital between January 2010 and May 2011 and 32 non-OSAS control subjects. All patients were given serum TSH, free T3 (fT3), free T4 (fT4), anti thyroid peroxidase (Anti-TPO), and anti-thyroglobulin (anti-TG) tests, as well as thyroid ultrasounds. We did not find any difference in prevalence of hypothyroidism, numbers of nodules and parenchyma heterogenicity determined by ultrasound, between OSAS subgroups and controls (p > 0,05). In this study, functional and ultrasonographic examination of the thyroid gland did not reveal any relationship between OSAS and thyroid disease. We believe hence that long-term follow-up studies can establish the possible significance of routine evaluation of OSAS patients for thyroid disease. © 2013 Springer Science+Business Media New York.


Arinc S.,Thoracic Surgery Training and Research Hospital | Gonlugur U.,Cumhuriyet University | Devran O.,Thoracic Surgery Training and Research Hospital | Erdal N.,Thoracic Surgery Training and Research Hospital | And 5 more authors.
Medical Oncology | Year: 2010

Background: The current prognosis in patients with small cell lung cancer (SCLC) is unsatisfactory, even though there have been considerable improvements in diagnosis and treatment. Methods: We retrospectively analyzed all consecutive patients with small cell lung carcinoma between 1995 and 2007 in a Turkish chest hospital. A total of 116 SCLC patients initially presented with limited disease, while 92 small cell lung carcinoma patients were found to be extensive. Results: The mean age of the patients (18 women and 190 men) was 56 years. The median survival was 74 weeks. Performance status, superior vena cava syndrome (SVCS), stage, elevated white blood cell count, elevated lactate dehidrogenase levels, short symptom duration (≤4 weeks) response to chemotherapy and bone metastasis were significant prognostic factors in univariate analysis. It was necessary for patients to receive at least three cycles of chemotherapy for a survival benefit. Cox proportional hazards model identified only stage, performance status and SVCS as independent prognostic factors. Conclusions: Stage, performance status and SVCS were determined to be the most important prognostic factors for SCLC patients. © 2009 Humana Press Inc.


Yilmaz I.,Ankara University | Oner Erkekol F.,Thoracic Surgery Training and Research Hospital | Secil D.,Ankara University | Misirligil Z.,Ankara University | Mungan D.,Ankara University
Occupational Medicine | Year: 2013

Background: Sensitivity and symptoms related to animal proteins have been investigated in various occupational groups. However, data from pet shops are limited. Aims: To investigate rates of sensitivity to cats and dogs among pet shop workers, to assess the relationship between sensitivity, allergen levels and symptoms and to investigate whether passive transport from pet shops to homes is possible. Methods: Pet shop workers underwent interviews with a questionnaire adapted from the European Community Respiratory Health Survey. Dust samples for allergen detection were collected from pet shops using a vacuum cleaner. Skin tests were performed with common allergens. Dust samples were also obtained from the houses of 7 workers and 12 control subjects. Results: Fifty-one workers from 20 pet shops were included in the study. Thirteen (25%) workers reported work-related symptoms. Four workers had sensitivity to animal allergens. The mean cat/dog allergen levels from pet shops were 15.7 and 3.2 μg/g, respectively. There was no significant relationship between cat/dog allergen levels and work-related symptoms and sensitivity to pets. None of the dust samples collected from the homes of pet shop workers contained cat allergens. Dog allergen was detected in only one house (0.58 μg/g). Neither cat nor dog allergens were found in the homes of the 12 control subjects. Conclusions: Although a quarter of pet shop workers reported work-related symptoms, sensitivity to cat and dog was low. These findings suggest that work-related symptoms may be due to other factors than cat and dog sensitivity. © The Author 2013. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved.


Firat Guven S.,Thoracic Surgery Training and Research Hospital | Turkkani M.H.,Thoracic Surgery Training and Research Hospital | Ciftci B.,Thoracic Surgery Training and Research Hospital | Ulukavak Ciftci T.,Gazi University | Erdogan Y.,Thoracic Surgery Training and Research Hospital
Sleep and Breathing | Year: 2012

Background and objective: There is an increased risk of cardiovascular and cerebrovascular events in patients with obstructive sleep apnea (OSA). High-sensitivity C-reactive protein (hs-CRP) is a marker that predicts atherosclerotic complications. However, there are contradictory results about the correlation between serum hs-CRP levels and OSA severity. The purpose of this work was to evaluate the relationship between hs-CRP levels and the severity of OSA in newly diagnosed OSA patients. Methods: The study group was composed of 76 patients with clinical suspicion of OSA. Subjects with body mass indexes (BMI) ≥30 kg/m 2 were classified as obese. Full-night polysomnography (PSG) was performed on all patients. Patients with an apnea-hypopnea index (AHI) ≥5 were considered to have OSA, and patients with an AHI<5 were accepted as the control group. Blood samples were taken from all patients to analyze serum hs-CRP levels the morning after PSG. Results: The serum hs-CRP levels were significantly higher in the OSA group (4.03±3.58 mg/L) than in the control group (2.41±1.95 mg/L) (p=0.013). This high level was positively correlated with BMI (r=0.376, p=0.001) and with AHI (r=0.280, p=0.014). In multiple regression analysis, elevated hs-CRP levels were associated with AHI (F=3.293, p=0.033), which was independent of obesity. Conclusions: Patients with OSA have elevated serum levels of hs-CRP, a marker for inflammation and an independent risk predictor for cardiovascular morbidity. The severity of OSA is responsible for the elevation of hs-CRP. © Springer-Verlag 2011.


Ucvet A.,Thoracic Surgery Training and Research Hospital | Sirzai E.Y.,Thoracic Surgery Training and Research Hospital | Yakut F.C.,Thoracic Surgery Training and Research Hospital | Yoldas B.,Thoracic Surgery Training and Research Hospital | Gursoy S.,Thoracic Surgery Training and Research Hospital
Archivos de Bronconeumologia | Year: 2014

Endometriosis is characterized by the growth of endometrium outside the uterine cavity or myometrium. There is no specific radiologic finding that defines endometriosis. Parenchymal lesions, nodules or blebs are reported in the literature, although this clinical entity is rare. Definitive diagnosis and treatment are often possible with surgery. We report here two cases: a forty-two-year-old female patient with a 2-year history of intermittent hemoptysis associated with her menstrual cycle was diagnosed as having endometriosis and treated via thoracotomy; another 30-year-old female referred to our department due to recurrent pneumothorax caused by underlying endometriosis underwent surgical treatment which revealed endometrial foci on the diaphragm. © 2013 SEPAR.


PubMed | Thoracic Surgery Training and Research Hospital
Type: Journal Article | Journal: Sleep & breathing = Schlaf & Atmung | Year: 2012

There is an increased risk of cardiovascular and cerebrovascular events in patients with obstructive sleep apnea (OSA). High-sensitivity C-reactive protein (hs-CRP) is a marker that predicts atherosclerotic complications. However, there are contradictory results about the correlation between serum hs-CRP levels and OSA severity. The purpose of this work was to evaluate the relationship between hs-CRP levels and the severity of OSA in newly diagnosed OSA patients.The study group was composed of 76 patients with clinical suspicion of OSA. Subjects with body mass indexes (BMI) 30 kg/m(2) were classified as obese. Full-night polysomnography (PSG) was performed on all patients. Patients with an apnea-hypopnea index (AHI) 5 were considered to have OSA, and patients with an AHI<5 were accepted as the control group. Blood samples were taken from all patients to analyze serum hs-CRP levels the morning after PSG.The serum hs-CRP levels were significantly higher in the OSA group (4.03 3.58 mg/L) than in the control group (2.41 1.95 mg/L) (p = 0.013). This high level was positively correlated with BMI (r = 0.376, p = 0.001) and with AHI (r = 0.280, p = 0.014). In multiple regression analysis, elevated hs-CRP levels were associated with AHI (F = 3.293, p = 0.033), which was independent of obesity.Patients with OSA have elevated serum levels of hs-CRP, a marker for inflammation and an independent risk predictor for cardiovascular morbidity. The severity of OSA is responsible for the elevation of hs-CRP.


Sahin F.,Thoracic Surgery Training and Research Hospital | Yildiz P.,Thoracic Surgery Training and Research Hospital
Journal of Thoracic Disease | Year: 2013

Objective: Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have EBTB were evaluated. Methods: Sixteen patients with at least three negative sputum examinations for acid-fast bacillus (AFB) and diagnosed as having EBTB on the histopathological examination of bronchoscopically obtained specimens showing granulomatous structures with caseation necrosis and/or positive AFB-culture on the microbiological examination of bronchoscopically obtained specimens were included in our study. Age, sex, symptoms, tuberculin skin test (TST), microbiological examination results and radiological findings were recorded. Bronchoscopical lesions were classified according to Chung classification. Results: EBTB was found to be more common in females. Most common symptoms were cough (100%), sputum (75%), weight loss (62.5%), hemoptisis (37.5%), chest pain (25%) and dyspnea (12.5%). Radiological examination findings revealed consolidations/infiltrations (87.5%), nodular lesions (37.5%), cavitary lesions (25%), unilateral (43.7%) or bilateral hilar widening (31.2%) and atelectasia (25%). Middle lob syndrome was seen in three cases. Most common lesions observed bronchoscopically were active caseous lesions, granular lesions, edematous hyperemic lesions, tumorous lesions, fibrostenotic lesions respectively. In all cases "granulomatous inflammation showing caseation" was shown in the histopathological examination of biopsy specimens. Conclusions: EBTB can cause various radiological and bronchoscopical findings. In most of the cases distinct response is seen to antituberculous treatment. Bronchial stenosis is an important complication. Treatment should be given as soon as possible to avoid it.

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