[Show abstract][Hide abstract] ABSTRACT: Hermansky-Pudlak syndrome is a rare disease characterized by bleeding diathesis, oculocutaneous albinism and lysosomal ceroid lipofuscin pigment deposits. Pulmonary fibrosis may also accompany with the disease. A 48-year-old male patient with a diagnosis of Hermansky-Pudlak syndrome admitted with dyspnea. A thorax computed tomography revealed bilateral diffuse interlobular septal thickness which was more prominent in the basal segments of lower lobes. Although pirfenidone therapy was planned, clinical deteroriation developed and patient died because of respiratory failure. In conclusion; this report describes a patient with pulmonary fibrosis caused by lung involvement of Hermansky-Pudlak syndrome which is an extremely rare and mortal disease.
[Show abstract][Hide abstract] ABSTRACT: Sarcoidosis is a multisystem granulomatous disorder of an unknown etiology. Subcutaneous sarcoidosis is a rare manifestation of sarcoidosis, and plantar involvement is extremely rare and there is only one such case report in the medical literature. Herein we present an interesting case of a patient who was diagnosed as having subcutaneous sarcoidosis at a plantar localization because plantar involvement is extremely rare and also because of the successful outcome after performing intralesional corticosteroid therapy.
Annals of Dermatology 11/2010; 22(4):435-8. · 0.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Epidermal growth factor receptor (EGFR) has been implicated as a factor indicating tumour progression or as a prognostic factor in non-small cell lung cancer (NSCLC), in which its overexpression is often detected. The usefulness of identifying EGFR in serum from patients with NSCLC is controversial. This study was designed to identify serum EGFR levels in patients with NSCLC and to evaluate the relationship between serum EGFR levels and clinical stage, histological subtype and survival time. Serum EGFR levels were measured using quantitative enzyme-linked immunosorbent assay. The study included 43 patients with NSCLC and 16 healthy controls. The histological classification was 29 squamous carcinomas and 14 adenocarcinomas. Serum samples were collected before treatment.There was no difference between serum EGFR levels in patients with NSCLC (17.53+/-8.09 fmol/mL) in comparison with those healthy controls (16.88+/-7.08 fmol/mL; p=0.912). There was also no difference in serum EGFR levels according to clinical stage or histological subtype. There was no relationship between serum EGFR levels and survival time in patients with NSCLC. The study's results suggest that, the utility of serum EGFR levels in patients with NSCLC as a tumour marker or as a prognostic factor is limited. However, further prospective studies on a large number of patients will be necessary to confirm this study's results.
[Show abstract][Hide abstract] ABSTRACT: We present three cases of septic pulmonary embolism which occurred as a result of three different causes. The first case, was a 23 year old woman suffering from cough, sputum, hemopthisis and pleuritic chest pain. She had a right subclavian port. On her thorax computed tomography (CT) scans there were widespread bilateral, irregular parenchymal nodular infiltrates and some of them beginning to cavitate. Meticilin resistant stafilococus aureus (MRSA) was isolated from the blood culture and septic embolism was diagnosed. A month after antibiotic theraphy her parenchymal nodules have considerably decreased in size. The second case was a 40 year old woman admitted to our hospital with the same complaints. Her radiological findings were similar. Meticilin sensitive stafilococus aureus (MSSA) was isolated from the blood cultures and antibiotic theraphy was initiated. To investigate the etiology of the nodules due to septic embolism, echocardiography was performed and infective endocarditis was diagnosed. After the antibiotic theraphy and a tricuspid valve operation her parenchymal nodules disappeared. The final case involved a 51 year old man suffering from fever, fatigue, cough and pain in the left arm for one week. His general status was bad. His radiological findings were also similar to the others. Staphillococcus aureus was isolated from blood and wound culture. Following clinical and radiological findings we thought it was a case of septic pulmonary embolism and antibiotic theraphy was started. Despite the therapy we did not take fever response and he died five days after antibiotic therapy. In conclusion, septic pulmonary embolism should be considered in bilateral cavitary nodular infiltrates and must be managed fast.
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo 07/2008; 69(2):75-7.
[Show abstract][Hide abstract] ABSTRACT: Polymorphism in plasminogen activator inhibitor-1 gene is suggested to be associated with an increased risk of venous thromboembolism. The aim of this study was to investigate the association of plasminogen activator inhibitor-1 gene polymorphism and its coexistence with factor-V-Leiden and prothrombin-20210 mutations in pulmonary thromboembolism. The authors investigated plasminogen activator inhibitor-1 4G/5G polymorphism, factor-V-Leiden, and prothrombin-20210 mutations in 143 pulmonary thromboembolism patients and 181 controls. Plasminogen activator inhibitor-1 4G/4G, 4G/5G, and 5G/5G gene polymorphisms and prothrombin-20210 mutations were not different between cases and controls. Factor-V-Leiden mutation was present in 21.0% and 7.7% of the cases and controls, respectively, P = .001. Neither different plasminogen activator inhibitor-1 genotypes and 4G allele nor coexistence of the allele with factor-V-Leiden or prothrombin-20210 was associated with the risk of recurrence. As a result, plasminogen activator inhibitor-1 gene polymorphism or its concomitant presence with mentioned mutations was not found to be associated with increased risk for pulmonary thromboembolism or recurrent disease in this study.
Clinical and Applied Thrombosis/Hemostasis 01/2008; 15(1):73-7. · 1.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Determining the aetiology of an effusion involves assessing if it is an exudate or a transudate. However, a reliable test for determining the aetiology of a pleural effusion is lacking. Pleural viscosity has a high sensitivity and specificity and a high positive and negative predictive value for discriminating exudative and transudative pleural effusions. The aim of this study was to use pleural fluid viscosity to discriminate between various aetiologies of exudative effusions, namely malignant, parapneumonic and tuberculous.
Seventy consecutive patients (24 women, 46 men, mean age = 67 years) with exudative pleural effusion due to pneumoniae in 24 patients, tuberculous pleurisy in 21 and lung cancer in 25 were studied prospectively. Measurements of pleural fluid and plasma viscosity were performed using Brookfield DV-II viscometer.
Pleural viscosity and pleural LDH were highest in the tuberculous pleurisy patients and lowest in the lung cancer patients. Pleural viscosity > or = 1.57 was found to be indicative of tuberculous pleurisy with a sensitivity of 100% and specificity of 95%. Pleural viscosity < 1.39 was found to be indicative of lung cancer with a sensitivity of 100% and specificity of 94%. Pleural viscosity was significantly correlated with pleural albumin (r = 0.34, P = 0.004), protein (r = 0.40, P = 0.001), LDH (r = 0.70, P < 0.001) and plasma viscosity (r = 0.44, P < 0.001), having the most significant value with pleural LDH.
The pleural fluid viscosity of patients with parapneumonic, tuberculous and malignant effusions are significantly different from each other. Among these groups, tuberculous effusions had the highest viscosity, and malignant effusions from lung cancer the lowest.
[Show abstract][Hide abstract] ABSTRACT: The initial step in establishing the cause of an effusion is to determine whether the fluid is a transudate or exudate. Plasma viscosity is influenced by the concentration of plasma proteins and lipoproteins with the major contribution resulting from fibrinogen. In this study we aimed to evaluate the role of pleural fluid viscosity in discrimination of transudate and exudates.
We studied prospectively 63 consecutive patients with pleural effusion in whom diagnostic or therapeutic thoracentesis had been performed. The criteria of Light were applied to differentiate transudates from exudates: 33 patients (23 male, 13 female, mean age=68+/-4 years) had exudates and 30 patients (17 male, 13 female, mean age=68+/-5) had transudates (due to congestive heart failure). Measurements of pleural fluid and plasma viscosity were performed using a viscometer.
There was no statistically significant difference between patients with transudate and exudates in respect to plasma viscosity. However, pleural viscosities of the patients with exudates were significantly higher than those of patients with transudate (1.37+/-0.16 mPa vs 0.93+/-0.03 mPa s p<0.001, respectively). Pleural viscosity has a high sensitivity, specificity (94%, 93%, respectively), positive and negative predictive value (97%, 97%, respectively) for the discrimination of transudative or exudatetive pleural fluid.
We have demonstrated for the first time that pleural viscosity of the exudative effusion is higher than that of transudative effusion with high sensitivity, specificity, positive and negative predictive value. Regarding the simplicity of this measurement, it may play a valuable role in the accurate and fast discrimination of pleural fluid.
Respiratory Medicine 07/2006; 100(7):1286-90. · 2.59 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Choriocarcinoma mostly metastasizes to lung parenchyma. Its pulmonary tumor embolism and cardiac metastasis are very rarely encountered, of which antemortem diagnosis is even more rare.
To our knowledge, we present the first case of intracavitary cardiac metastasis and pulmonary tumor emboli of choriocarcinoma diagnosed and treated without any surgical intervention. Multi-agent chemotherapy led to almost complete regression of cardiac and pulmonary lesions and normalization of beta-hCG levels.
Cardiac metastasis of choriocarcinoma must be kept in mind for cases of cardiac mass in reproductive age women, especially when history and clinical presentation are suggestive for gestational trophoblastic disease. As the tumor is highly sensitive, chemotherapy together with biochemical and radiological monitoring constitutes an effective treatment modality if cardiopulmonary functions are not deteriorating.
[Show abstract][Hide abstract] ABSTRACT: Objective: The aim of the study was to investigate whether factor V Leiden and prothrombin G20210A mutations, elevated levels of factor VIII and factor IX are associated with pulmonary embolism (PE).Methods: Sixty-four patients with objectively documented PE and 64 control subjects were included in this study. The authors divided the 64 subjects with PE into those with PE and deep vein thrombosis (combined form of venous thromboembolism, n = 26) and those with PE without deep vein thrombosis (isolated PE n = 38).Results: There was no significant difference between the PE groups and the control subjects with regard to the presence of factor V Leiden and prothrombin mutations and elevated levels of factor IX. Using the 90th percentile measured in control subjects (P90 = 168 U/dL) as a cut-off point for factor VIII levels, the authors found an 11-fold increased risk for both isolated PE patients and patients with a combined form of venous thromboembolism who have factor VIII levels >168 U/dL compared with individuals having factor VIII levels below this cut-off point. The risk was not affected by adjustments for other possible risk factors.Conclusions: Elevated plasma factor VIII levels were found to be a significant, independent risk factor for PE.
[Show abstract][Hide abstract] ABSTRACT: A 48 year-old man, without any systemic disease, was admitted to our hospital with a complaint of decreased visual acuity and pain in his left eye. The orbital magnetic resonance imaging revealed metastatic lesions and further evaluations disclosed a primary lung cancer.
[Show abstract][Hide abstract] ABSTRACT: There are many studies supporting the family history in lung cancer. In this study, we observed 1500 with lung cancer cases diagnosed between the years 1995-2000 in our clinic, and investigated family tendency of lung cancer in a control group including partners of 600 patients with family history of cancer. We conducted face-to-face interviews with 100 patients with lung cancer, and with first degree relatives of the other 1400 patients with lung cancer. There were 600 positive family history of cancer. Control populations were matches of the cancer patients with positive family history of cancer. Cases and controls were asked to report on their family history of cancer, as well as smoking status of family members. In conclusion, in 40% of 1500 patients with lung cancer, there was positive family history of lung cancer with regard to malignity. This positive family history of cancer was consisted of 51.8% lung cancer, 35.5% digestive cancer and 12.7% other cancers such as breast, larynx, prostate and bone. In control group, the value of the positive family history of lung cancer with regard to malignity was 5.0% (p< 0.001). These results support the hypothesis of a genetic susceptibility by showing that the patients with lung cancer have significantly more positive family history of lung cancer and digestive cancer.
[Show abstract][Hide abstract] ABSTRACT: Based on data providing a correlation between immunoglobulin or complement components levels and malignancies and specific disease parameters, we examined the possible correlation between the immunoglobulins, complement component levels and the stage of disease and the survival of patients. Sera from 55 patients with lung cancer and 22 healthy donor were assayed in order to evaluate the concentration of IgG, IgA, IgM, IgE, C3, C4. No considerable differences were found between the levels of immunoglobulins in patients with carcinoma of the lung versus subjects in the control group. Complement components (C3 and C4) levels were elevated in cancer patients with different cell types compared with levels in the control group. No statistically significant differences were found between the levels of the studied parameters and the stage of the disease and the survival time of patients. Our study confirm the hypothesis that malignant tumours contribute to elevation of complement components levels but additional studies are needed for demonstrating the prognostic value of immunoglobulin and complement components levels in lung cancer patients.
[Show abstract][Hide abstract] ABSTRACT: Behçet's disease is currently recognized as a multisystemic disease that may present with vascular, cutaneous, pulmonary, neurologic, rheumatologic, gastrointestinal, and genitourinary manifestations. Despite this multiplicity, cardiac involvement and also the coexistence of bilateral pulmonary arterial aneurysms are rare. An interesting case is presented here with intracardiac thrombi and bilateral pulmonary arterial aneurysms that showed clinical regression with immunosuppressive therapy.
[Show abstract][Hide abstract] ABSTRACT: Styrene, a volatile monomer, has been reported as a cause of occupational asthma in a few case reports.
The aim of this study was to investigate the risk for asthma in relation to exposure to styrene in a large number of workers.
A total of 47 workers with a history of exposure to styrene were included in the study. To establish whether asthma was present, each patient underwent a clinical interview, pulmonary function testing and bronchial challenge with methacholine. Specific bronchial challenges with styrene and serial peak expiratory flow (PEF) measurement at home and at work were carried out in subjects with a diagnosis of asthma to evaluate the relationship between their asthma and exposure to styrene in the workplace.
Among the 47 subjects, 5 workers had given a history of work-related symptoms, and 3 of them had a positive methacholine challenge test. Specific bronchial challenges with styrene and serial PEF measurement were subsequently carried out in these 3 subjects. Although provocation tests with styrene were negative in the 3 workers, 1 worker had PEF rate records compatible with occupational asthma.
We established one patient with occupational asthma from a group of people who have excessive styrene exposure. This finding may be suggestive but is not conclusive about the causative role of styrene in occupational asthma. Since styrene is a frequently used substance in the furniture industry, it is worth performing further studies to investigate the relationship between styrene and occupational asthma.
[Show abstract][Hide abstract] ABSTRACT: Behçet’s disease is currently recognized as a multisystemic disease that may present with vascular, cutaneous, pulmonary, neurologic, rheumatologic, gastrointestinal, and genitourinary manifestations. Despite this multiplicity, cardiac involvement and also the coexistence of bilateral pulmonary arterial aneurysms are rare. An interesting case is presented here with intracardiac thrombi and bilateral pulmonary arterial aneurysms that showed clinical regression with immunosuppressive therapy.
[Show abstract][Hide abstract] ABSTRACT: Up to date several hereditary disorders have been identified as prothrombic risk factors. The most common inherited thrombotic disorders include activated protein C resistance (factor V Leiden), prothrombin G20210A mutation, hyperhomocysteinemia, deficiencies of protein C, protein S, antithrombin III, and thrombomodulin. This article focuses on the clinical and the laboratory aspects of some of the inherited venous thrombotic disorders including the factor V Leiden, prothrombin G20210A mutation and protein S deficiency.
[Show abstract][Hide abstract] ABSTRACT: In the work places the worker may be exposed to environmental materials and substances that in some cases trigger respiratory problems. In this ambience, asthma is a common occupational problem that far exceeds other causes of occupational pulmonary disease. The epidemiology and the predisposing factors of occupational asthma, some of agents that causes occupational asthma, and the diagnosis of the disease will be reviewed in this brief discussion.
[Show abstract][Hide abstract] ABSTRACT: A number of disorders for which an association with hepatitis C virus infection exist. These disorders include essential mixed cryoglobulinemia, membranoproliferative glomerulonephritis, and idiopathic pulmonary fibrosis. This study was initiated to investigate the cellular content and lymphocyte subpopulations of bronchoalveolar lavage fluid obtained from individuals with chronic hepatitis C and to compare the results to those of controls. Eighteen patients with chronic hepatitis C (male/female, 6/12) and 14 healthy volunteers (male/female, 6/8), were studied. Bronchoalveolar lavage fluid was obtained from each; and the lymphocyte subtypes and the presence of HCV-RNA in the bronchoalveolar lavage fluid were determined. All anti-HCV positive subjects were HCV-RNA positive in serum. One (5.6%) had a HCV-RNA positive bronchoalveolar lavage. The total cell and neutrophil counts of the bronchoalveolar lavage fluid were significantly greater in patients with chronic hepatitis C as compared to controls (5,799.6 +/- 957.4 x 10(3)/ml vs. 1,835.7 +/- 447.8 x 10(3)/ml, P = 0.001; 1,175.8 +/- 634.7 x 10(3)/ml vs. 53.1 +/- 28.1 x 10(3)/ml, P = 0.029). In contrast, the lymphocyte, macrophage and eosinophil counts did not differ. No difference in the percentage, median or range of individual T cell subsets or B cell numbers in the bronchoalveolar lavage fluid existed between the groups. It is concluded that hepatitis C virus infection may be associated with an occult pulmonary inflammatory reaction manifested by an increased number of polymorphonuclear neutrophils in bronchoalveolar lavage fluid. This finding may contribute to the process that leads to idiopathic pulmonary fibrosis seen in a minority of cases of chronic hepatitis C.
Journal of Medical Virology 02/2002; 66(1):34-9. · 2.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Transthoracic needle aspiration is not a recommended diagnostic modality in hydatid disease. Percutaneous aspiration of a suspected hydatid cyst is believed to be associated with the risk of allergic reactions which can result in systemic anaphylaxis and possible spreading of the cyst contents. We present herein a illustrative case of pulmonary hydatid cyst and multiple mediastinal lymphadenopathies which was diagnosed after repeated transthoracic fine needle aspirations.