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Yildirim D.,Kasimpasa Military Hospital | Tamam M.,Okmeydani Training and Research Hospital | Sanli Y.,Istanbul University | Ozgul M.A.,Yedikule Chest Disease and Chest Surgery Education and Research Hospital | Somay A.,Vakif Gureba Education and Research Hospital
European Review for Medical and Pharmacological Sciences | Year: 2012

PURPOSE: We aimed to put forward the contribution of virtual bronchoscopy in the determination and diagnosis of tracheo-bronchial system pathologies. We compared the data obtained from PET/CT and virtual bronchoscopy (VB) with the fiberoptic bronchoscopy (FOB) data of the cases with a diagnosis or prediagnosis of lung tumor. MATERIALS AND METHODS: A total of 261 (male=238, female=23) lung cancer cases with a mean age of 53±7.3 years (range =35-77 years), who had undergone FOB and had bronchoalveolar lavage and/or biopsy results, were included in this multicenter, prospective study conducted between 2006 and 2008. FOB data confirmed with cytohistopathology were considered as the gold standard. Five cases that had peripheral lesions, with negative cytopathological results were excluded from the study. Positron emission tomography images were fused with 16/slice multi-detector computed tomography system images (Discovery ST PET/16 slice CT fusion system HPOWER 60; General Electric Medical Systems, Milwaukee, WI, USA). Thereafter, all of the cases were evaluated with virtual bronchoscopy, using a special multidisplay workstation with multiplanar reformatting (MPR) and minimum intensity projection (MINIP) to see the fused images simultaneously. The data obtained with both virtual bronchoscopy (PET/CT VB) and FOB in different centers were recorded, and the evaluation and comparison of these data were done by an independent researcher. The sensitivity, specificity, and positive and negative predictive values of making an accurate diagnosis and defining concomitant pathologies by both methods, were calculated. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy values of VB and PET/CT-VB in determining the segment involved by malignancy were as follows, 91%, 83%, 94%, 77%, and 89%, and 95%, 97%, 99%, 87%, and 96%, respectively. CONCLUSIONS: The sensitivity of PET/CT-VB in determining the involved tracheobronchial segment(s) in malignancy and concomitant pathologies in cases with lung tumor was remarkably higher than that with CT-VB. Therefore, PET/CT-VB is recommended to be included in routine lung cancer examinations since it provides similar outcomes to that of FOB+cytohistopathological examination. Source


Korkmaz G.G.,Kirklareli University | Inal B.B.,Istanbul Education and Research Hospital | Ortakoylu G.M.,Yedikule Chest Disease and Chest Surgery Education and Research Hospital | Irmak H.,Istanbul University | And 4 more authors.
Clinical Laboratory | Year: 2014

Introduction: The source of many diseases, including tumors, lies in an increased generation of reactive oxygen species resulting in oxidative stress. We investigated the relationships between advanced oxidation protein products (AOPPs), nitrotyrosine (NT), protein carbonyls (PCO) content, and the prooxidant-antioxidant balance (PAB) in patients with lung cancer. Methods: A total of 14 age-matched healthy controls, 14 subjects with non-lung cancer pulmonary disease, and 41 patients with lung cancer were included in this study. Spectrophotometry was used to examine plasma AOPP, serum FRAP, and PAB, while serum PCO and NT were assessed with western blot analysis. Results: A significant difference in AOPP levels were found between patients and controls (p < 0.01). Also, there was a highly significant difference in NT levels between patients and controls (p < 0.001). PAB showed negative correlation with albumin (r = -0.340, p = 0.011) and positive correlation with CRP (r = 0.342, p = 0.011). AOPP, albumin, gender, and smoking were the significant independent variables found by backward stepwise multiple logistic regression (MLR) analysis method. MLR analysis revealed that AOPP was the variable that had a significant effect on lung cancer [(p = 0.006, OR = 1.074, (95% CI) (1.020 - 1.131)]. Conclusions: The use of non-invasive diagnostic biochemical parameters would represent a very important contribution to our diagnostic armamentarium in lung cancer, considering the high incidence of this deadly disease. In this regard, AOPP and NT levels have appeared to play a prominent role, although further studies are certainly warranted. Source


Yurt S.,Yedikule Chest Disease and Chest Surgery Education and Research Hospital | Erman H.,Istanbul University | Korkmaz G.G.,Kirklareli University | Kosar A.F.,Yedikule Chest Disease and Chest Surgery Education and Research Hospital | And 4 more authors.
Clinical Biochemistry | Year: 2013

Purpose: Malnutrition is a prominent feature of tuberculosis (TB). The aim of our study was to explore the function of plasma regulatory proteins in pulmonary TB and to investigate the relationship between these parameters and loss of body weight. Methods: Plasma levels of fasting insulin, leptin, ghrelin, adiponectin and orexin-A were measured in 23 pulmonary TB patients, 39 patients with pulmonary sarcoidosis, 22 patients with different diffuse interstitial lung diseases and 21 healthy patients serving as controls. Result: Plasma leptin (p < 0.001) and orexin-A (p < 0.01) levels were significantly decreased in TB patients compared with those of the other study subjects. TB patients also had higher levels of plasma ghrelin compared with those of the other study subjects, while sarcoidosis patients had higher plasma adiponectin levels than the other study subjects. Glucose levels were similar in all groups, yet, insulin and Homeostasis Model of Assessment-Insulin Resistance (HOMA-IR) levels were significantly higher in the TB group compared to the other study groups. There was no correlation between leptin, ghrelin, adiponectin and orexin-A and other parameters. Conclusions: These data suggest that leptin and orexin-A levels have effects on weight loss in patients with pulmonary tuberculosis. Particularly, leptin may play a role in the early immune response to pulmonary TB and prolonged inflammation may further suppress leptin production. Measurement of HOMA-IR can indeed be used as a marker for the risk of activated TB. Further clinical studies are needed to better understand the role of feed regulating proteins in pulmonary tuberculosis. © 2012 The Canadian Society of Clinical Chemists. Source

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