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Aydin S.,Istanbul University | Aytac E.,Istanbul University | Uzun H.,Istanbul University | Altug T.,Istanbul Science University | And 4 more authors.
Asian Journal of Surgery | Year: 2010

OBJECTIVE: Obstructive jaundice develops after occlusion of the common bile duct. Direct hyperbilirubinaemia, which occurs secondary to the condition, causes various life-threatening pathologies. Cytoprotective effects of Ganoderma lucidum (GL) have previously been shown. In this study, the effects of GL on oxidative stress and oxidant DNA damage in experimental obstructive jaundice were evaluated. METHODS: Sixty Wistar albino adult female rats were randomly divided into six weight-matched equal groups: sham group, bile duct ligated group (BDL); after sham operation 250 mg/kg/d of GL administered group, after sham operation 500 mg/kg/d of GL administered group, after bile duct ligation 250 mg/kg/d of GL administered (GL1BDL) group, and after bile duct ligation 500 mg/kg/d of GL administered (GL2BDL) group. GL polysaccharide was orally administered to the rats via gavage tube once a day for 14 days after bile duct ligation. RESULTS: The plasma malondialdehyde levels of the GL1BDL and GL2BDL groups were significantly lower than those of the BDL group (p < 0.01). The plasma 8-hydroxy-2′-deoxyguanosine levels of the GL1BDL and GL2BDL groups were significantly lower than those of the BDL group (p < 0.001). The liver tissue Cu-Zn superoxide dismutase level of the GL2BDL group was significantly higher than that of the BDL group (p < 0.05). CONCLUSION: GL protected against DNA and liver tissue damage by reducing oxidative stress in obstructive jaundice. © 2010 Asian Surgical Association. Source


Kiran B.,Istanbul University | Cagatay T.,Istanbul University | Clark P.,Yeditepe University | Kosar F.,Yedikule Chest Diseases and Chest Surgery Education and Research Hospital | And 4 more authors.
Archives of Medical Science | Year: 2010

Introduction: Despite the development and wide implementation of Directly Observed Therapy Strategies (DOTS), multidrug-resistant tuberculosis (MDR-TB) remains a serious global health threat. In this study, the role of host immune response in patients with MDR-TB is investigated and compared with that of patients with smear-positive drug-sensitive tuberculosis (SP-TB). Material and methods: 27 patients with SP-TB, 20 patients with MDR-TB, and 20 healthy controls were included in the study. Immune parameters were determined by flow cytometry using monoclonal antibodies in order to compare the percentage values of these markers in the two study groups and the control group. Results: The levels of lymphocyte subgroups in the gate of CD45(+)/CD14(-) lymphocyte: CD45(+), CD3(+), CD4(+), NK, CD3/HLA-DR, CD 95(+) cells were significantly lower; by contrast CD23(+), CD25(+), CD19(+), CD4(+)/CD8(+), HLA-DR cells were found to be lower, but not significantly so in patients with MDR-TB, compared to levels in patients in the SP-TB and control groups. Besides these findings, the levels of NKT cells and γδ TCR(+) cells were significantly higher in the MDR-TB than in the healthy control and SP-TB group. Conclusions: The lower levels of CD3/HLA-DR, CD4 (+), Fas (+), and NK, and the higher level of NKT together with γδ T cells in patients with MDR-TB compared to those in SP-TB may indicate a profound immune suppression in MDR-TB patients and thereby may denote an accumulation in the bacterial load. Our findings may shed light on the pathogenesis and prognosis of MDR tuberculosis, and may point towards the use of flow cytometry findings as an aid to early diagnosis in MDR-TB patients. Copyright © 2010 Termedia & Banach. Source


Okumus G.,Istanbul University | Musellim B.,Istanbul University | Cetinkaya E.,Yedikule Chest Diseases and Chest Surgery Education and Research Hospital | Turker H.,Sureyyapasa Training and Research Hospital for Chest Diseases and Thoracic Surgery | And 21 more authors.
Respirology | Year: 2011

Background and objective: Extrapulmonary sarcoidosis is common, and is almost always associated with concomitant thoracic involvement. Extrapulmonary manifestations vary on the basis of gender, age at presentation and ethnicity. The aim of this study was to investigate extrapulmonary involvement in patients with sarcoidosis in Turkey. Methods: This study was conducted by Turkish Thoracic Society Clinical Problems Study Group.New cases of sarcoidosis between 1 June 2004 and 31 May 2006 were recorded on electronic case record forms sent to all potential investigators and information about extrapulmonary involvement was collected. Results: One hundred and nineteen of 293 patients (83 female, 36 male, mean age = 45 ± 12 years) had extrapulmonary involvement in this study (40.6%).The median time to diagnosis was 6 months and this was longer than patients with just thoracic sarcoidosis (P = 0.001). Extrapulmonary symptoms were present in 181 (61.8%) patients,and skin lesions, arthralgia and back pain were the commonest (33.4%, 20.8% and 16.4%, respectively). Incidence of organ involvement was independent of age with the exception of ocular involvement, which was higher in those under the age of 40 years (P = 0.007). Conclusions: Skin and peripheral lymph node involvement were the most common sites of extrapulmonary involvement and ocular involvement was more common in those under the age of 40 years in patients with sarcoidosis in a Turkish population. © 2011 The Authors Respirology © 2011 Asian Pacific Society of Respirology. Source


Urer H.N.,Yedikule Chest Diseases and Chest Surgery Education and Research Hospital | Ahiskali R.,Marmara University | Arda N.,Yedikule Chest Diseases and Chest Surgery Education and Research Hospital | Batur S.,Istanbul University | And 11 more authors.
Turk Patoloji Dergisi/Turkish Journal of Pathology | Year: 2014

Objective: The aim of this study was to investigate the interobserver agreement in determination of the dominant histological pattern and the final diagnosis in lung adenocarcinomas. Material and Method: A total of 12 patients with a diagnosis of primary lung adenocarcinoma were included in the study. Twelve pathologists from eight study centers were asked first to determine the dominant histological pattern in these cases and then to decide whether the final diagnosis was in situ, minimally invasive or invasive adenocarcinoma. Results: The kappa value for the agreement in determining the dominant pattern among the pathologists was 0.36 (p<0.001), with the values for the lepidic, acinar, papillary, solid, micropapillary patterns and mucinous character of adenocarcinoma being 0.34, 0.28, 0.30, 0.80, 0.16 and 0.38 respectively (p<0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001). None of the cases was diagnosed as in situ adenocarcinoma. On the other hand, the kappa value for the agreement in differentiating minimally invasive from invasive adenocarcinoma among reviewers was 0.17 (p<0.001). Conclusion: The agreement among pathologists in determining the subtype of lung adenocarcinomas that depends on the identification of the dominant pattern was at intermediate level. In addition, the agreement in deciding whether the case is minimally invasive or invasive, was at low level. The criteria defining the histological patterns should be clarified and described in more detail. Educational activities and larger multicenter studies might be helpful in improving the agreement and standardization. Source


Yurdakul A.S.,Gazi University | Kocaturk C.,Yedikule Chest Diseases and Chest Surgery Education and Research Hospital | Bayiz H.,Ataturk Chest Diseases and Chest Surgery Education and Research Hospital | Gursoy S.,Izmir Suat Seren Chest Diseases and Chest Surgery Education and Research Hospital | And 38 more authors.
Cancer Epidemiology | Year: 2015

Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients with lung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis and treatment of NSCLC and the factors affecting these delays. Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with a mean age of 61.5. ±. 10.1 years, were enrolled prospectively in this study between May 2010 and May 2011 from 17 sites in various Turkish provinces. Results: The patient delay was found to be 49.9. ±. 96.9 days, doctor delay was found to be 87.7. ±. 99.6 days, and total delay was found to be 131.3. ±. 135.2 days. The referral delay was found to be 61.6. ±. 127.2 days, diagnostic delay was found to be 20.4. ±. 44.5 days, and treatment delay was found to be 24.4. ±. 54.9 days. When the major factors responsible for these delays were examined, patient delay was found to be more frequent in workers, while referral delay was found to be more frequent in patients living in villages (. p<. 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctors who were consulted by patients increased (. p<. 0.05). Additionally, we determined that diagnostic and treatment delays were more frequent at the early tumour stages in NSCLC patients (. p<. 0.05). Discussion: The extended length of patient delay underscores the necessity of educating people about lung cancer. To decrease doctor delay, education is a crucial first step. Additionally, to further reduce the diagnostic and treatment delays of chest specialists, multidisciplinary management and algorithms must be used regularly. © 2015 Elsevier Ltd. Source

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