PROF. DR. ENDER LEVENT

Görev Aldığı Bölümler

Göğüs Hastalıkları

Obstructive sleep apnea syndrome and anthropometric obesity indexes

By

Soylu, AC (Soylu, Akin Cem) [2] ; Levent, E (Levent, Ender) [1] , [2] ; Sariman, N (Sariman, Nesrin) [2] ; Yurtlu, S (Yurtlu, Sirin) [2] ; Alparslan, S (Alparslan, Sumeyye) [2] ; Saygi, A (Saygi, Attila) [2]

 (provided by Clarivate) 

Source

SLEEP AND BREATHING

Volume

16

Issue

4

Page

1151-1158

DOI

10.1007/s11325-011-0623-9

Published

DEC 2012

Indexed

2012-12-19

Document Type

Article

Abstract

The purpose of this study is to investigate whether the general body adiposity or regional adiposity was a risk factor in the evolution of obstructive sleep apnea syndrome (OSAS) by examining the relationships between the anthropometric obesity indexes such as waist (WC) and neck circumference index (NC), body mass index (BMI), and OSAS in Turkish adult population, and to access the possible differences by gender.

The data related to polysomnographic, demographic, and anthropometric indexes of the 499 subjects were examined retrospectively. The patients whose apnea-hypopnea index was a parts per thousand yen5 were determined as OSAS group.

The avarage BMI, WC, and NC of the OSAS group (n = 431) were statistically higher than the control group (p < 0.001). According to logistic regression analysis, BMI, WC, and NC enlargement were observed as significant risk factors for OSAS development. Risk coefficients were determined 5.53 for NC, 4.48 for WC, and 2.22 for BMI. Cutoff point values for anthropometric obesity indexes as OSAS determiner were recorded as below: BMI for male > 27.77 kg/m(2) and female > 28.93 kg/m(2), NC index for male > 40 cm and female > 36 cm, and WC index for male > 105 cm and female > 101 cm.

BMI, WC, and NC enlargement were determined as significant risk factors for OSAS development. This was an initial study to determine the cutoff points of which increase the OSAS risk in BMI, WC, and NC index in Turkish adult population.

Keywords

Author Keywords

Body mass index Neck circumference Obesity Obstructive sleep apnea syndrome Waist circumference

Lung cancer and pregnancy

By

Sariman, N (Sariman, Nesrin) [1] ; Levent, E (Levent, Ender) [1] ; Yener, NA (Yener, Nese Arzu) [2] ; Örki, A (Orki, Alpay) [3] ; Saygi, A (Saygi, Attila) [1]

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Source

LUNG CANCER

Volume

79

Issue

3

Page

321-323

DOI

10.1016/j.lungcan.2012.11.014

Published

MAR 2013

Indexed

2013-03-20

Document Type

Article

Abstract

Lung cancer in the pregnant woman is a very rare and dramatic coincidence with poor prognosis. Treatment depends on the gestational week of the pregnancy, patient's medical status, social, personal, familial, and even religious beliefs. We present a case of adenocarcinoma of the lung in a 34-year-old pregnant patient whose initial complaints were cough, dyspnea, fever and fatigue. She was diagnosed with pneumonia at another hospital, and antibiotic therapy was administered. Meanwhile, at 28 weeks she delivered a preterm low-birth-weight baby. Chest X-ray and thorax CT revealed a mass lesion in the upper left lung lobe. After admission to our clinic, needle aspiration of left supraclavicular lymph node and bronchoscopic biopsy from upper lobe bronchus showed a non-small lung cancer; adenocarcinoma. Brain MRI was normal. PET CT revealed multiple bone metastases. Multidisciplinary Tumor Committee at our hospital referred her to the Oncology Department as an advanced stage IV disease. Chemotherapy was administered with paclitaxel and carboplatin for a total of 12 weeks. Reassessment of the patient revealed new bone metastases and crizotinib was administered since her tumor was found positive for EML4-ALK mutations. The treatment was well tolerated. During a follow up period of 6 months her clinical condition was stable and no adverse events were encountered. (c) 2012 Elsevier Ireland Ltd. All rights reserved.

Keywords

Lung cancer in pregnancy Adenocarcinoma Diagnosis Smoking

Nonsevere Acute Pulmonary Embolism: Prognostic CT Pulmonary Angiography Findings

By

Atasoy, MM (Atasoy, Mehmet Mahir) [1] ; Sariman, N (Sariman, Nesrin) [2] ; Levent, E (Levent, Ender) [2] ; Çubuk, R (Cubuk, Rahmi) [1] ; Çelik, Ö (Celik, Omer) [3] ; Saygi, A (Saygi, Attila) [2] ; Atasoy, I (Atasoy, Isil) [4] ; Sahin, S (Sahin, Sinan) [5]

 (provided by Clarivate) 

Source

JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY

Volume

39

Issue

2

Page

166-170

DOI

10.1097/RCT.0000000000000201

Published

MAR-APR 2015

Indexed

2015-04-22

Document Type

Article

Abstract

Purpose: To retrospectively evaluate the prognostic parameters of computed tomography (CT) pulmonary angiographic findings in nonsevere (hemodynamically stable) pulmonary embolism(PE) patients and to assess the predictive value of these parameters for mortality within 1 month of the initial diagnosis.

Materials and Methods: Retrospectively, 67 consecutive patients (28 men, 39 women; mean age, 63.25 +/- 18 years) from 2 centers with nonsevere PE diagnosed using CT and a clinical evaluation were included in the current study. Using consensus reading, 2 readers blinded to the patients' clinical outcomes quantified the right ventricle short axis to left ventricle short axis ratio in the axial plane, vascular measurements, reflux of contrast medium into the inferior vena cava and azygos vein, ventricular septal bowing, and clot load using the Qanadli scoring system. The Simplified Pulmonary Embolism Severity Index (sPESI) and pulmonary parenchymal findings were also evaluated. All CT pulmonary angiographic parameters were compared with the risk of death within 1 month using logistic regression analysis.

Results: Fifty-nine patients survived (88.1%), and 8 patients (11.9%) died because of PE. The sPESI and 2 parenchymal findings (multiple wedge-shaped opacities or consolidation accompanied by a wedge-shaped opacity) were significantly related tomortality. In the univariate analysis, neither the cardiovascular CT parameters nor the clot burden was significant between the survivors and nonsurvivors (P > 0.05).

Conclusions: In clinically nonsevere PE patients, the sPESI and significant parenchymal findings were the CT parameters related to 1-month mortality.

Author Keywords

pulmonary embolism nonsevere hemodynamically stable computerized tomography pulmonary angiography prognostic findings

Bronchial hyperreactivity and airway wall thickening in obstructive sleep apnea patients

By

Sariman, N (Sariman, Nesrin) [1] ; Levent, E (Levent, Ender) [1] ; Çubuk, R (Cubuk, Rahmi) [2] ; Yurtlu, S (Yurtlu, Sirin) [1] ; Aksungar, FB (Aksungar, Fehime Benli) [3]

 (provided by Clarivate) 

Source

SLEEP AND BREATHING

Volume

15

Issue

3

Page

341-350

DOI

10.1007/s11325-010-0387-7

Published

SEP 2011

Indexed

2011-10-26

Document Type

Article

Abstract

Hypoxia/reoxygenation episodes in obstructive sleep apnea (OSA) results in the alteration of the oxidative balance, leading to the development of inflammation. Airway wall thickening and inflammatory changes are suggested as a primary cause of the airway hyperresponsiveness in asthmatics. Bronchial hyperreactivity (BH) may also occur in patients with OSA. We investigated the presence of BH and airway wall thickness in OSA and correlations with inflammatory markers.

Sixteen OSA patients and ten controls without allergic diseases were prospectively studied. Plasma pro-B-type natriuretic peptide (pro-BNP), fibrinogen, D-dimer, alpha 1-antitrypsin, and high-sensitive C-reactive protein levels were measured. Airway wall thickness was evaluated with high-resolution CT, and BH was assessed by giving each subject a methacholine challenge test.

In OSA patients, bronchial wall thickness, fibrinogen, D-dimer, alpha 1-antitrypsin, high sensitive C-reactive protein, and pro-BNP levels were significantly greater than those in control subjects. Among the 16 patients, three had BH on methacholine challenge. Bronchial wall thickness(mm) was positively correlated with apnea-hypopnea index (AHI: number of apneas + hypopneas/hour of sleep), BMI, respiratory arousal index, nocturnal oxygen desaturation (NOD) duration (time in minutes with a nocturnal arterial oxygen saturation of < 90% during sleep), and alpha 1-antitrypsin levels. NOD duration also correlated with pro-BNP and fibrinogen levels.

In OSA patients, walls of central airways were thicker than normal subjects. BH may have occurred in OSA patients. NOD duration correlated with inflammatory parameters and oxygen desaturation index 3% had an effect on the thickness of bronchial walls. But overall, AHI was found to be the only independent predictor of bronchial wall thickness.

Keywords

Author Keywords

Airway wall thickening Bronchial hyperreactivity Obstructive sleep apnea High-resolution computerized tomography

Idiopathic chylothorax in geriatrics: the oldest case report so far

By

Ipek, BÖ (Ipek, Belkiz Ongen) [1] , [2] ; Alasehir, EA (Alasehir, Elcin Akduman) [3] ; Sitar, ME (Sitar, Mustafa Erinc) [2] ; Levent, E (Levent, Ender) [4] ; Orki, A (Orki, Alpay) [5]

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Source

TURKISH JOURNAL OF BIOCHEMISTRY-TURK BIYOKIMYA DERGISI

Volume

43

Issue

5

Page

564-567

DOI

10.1515/tjb-2018-0193

Published

OCT 2018

Indexed

2018-11-22

Document Type

Article

Abstract

Chylothorax is a rare condition characterized by accumulation of chylous fluid in the pleural space resulting in impaired ductus thoracic integrity. It can be an outcome of a traumatic process, although there are a few non-traumatic and/or idiopathic cases in current literature. In this article, we present the oldest case report so for, who is an 87-year-old woman complaining of acute respiratory distress symptoms with pleural effusion having no trauma history. The patient was analyzed for the disease etiology strenuously. Thoracentesis was performed together with imaging modalities and detailed systemic laboratory tests. Non-surgical treatment was successful as the outcome.

Keywords

Author Keywords

Chylothorax Geriatrics Pleural fluid

Homocysteine Levels and Echocardiographic Findings in Obstructive Sleep Apnea Syndrome

By

Sariman, N (Sariman, Nesrin) [1] ; Levent, E (Levent, Ender) [1] ; Aksungar, FB (Aksungar, Fehime Benli) [2] ; Soylu, AC (Soylu, Akin Cem) [1] ; Bektas, O (Bektas, Osman) [3]

 (provided by Clarivate) 

Source

RESPIRATION

Volume

79

Issue

1

Page

38-45

DOI

10.1159/000210429

Published

2010

Indexed

2010-01-01

Document Type

Article

Abstract

Background: The obstructive sleep apnea syndrome (OSAS) is characterized by repeated upper airway obstruction during sleep together with decreases in oxygen saturation leading to a series of pathological events, primarily in the cardiovascular system. Elevated plasma homocysteine levels have recently been considered as an independent risk factor for vascular disease, and increased levels are attributed to cardiovascular diseases. Objectives: We aimed to investigate the possible relationship between homocysteine levels and echocardiographic findings in OSAS patients at different stages of disease. Methods: Thirty-eight patients (23 males and 15 females) with polysomnographically verified OSAS (mean age, 49 +/- 12 years, range 27-74) and a mean body mass index of 31.27 +/- 5.24 kg/m(2) (range 22.60-47.90) were prospectively studied. Plasma levels of homocysteine, cholesterols, triglycerides, vitamin B-12 and high-sensitive C-reactive protein (hsCRP), as well as echocardiographic and lung function parameters were assessed. Results: Homocysteine levels were elevated in all OSAS groups and were statistically significantly different between the mild and moderate/severe groups. Significant differences were present between the variables nocturnal oxygen desaturation (NOD), respiratory arousal and light sleep among the mild and moderate/severe groups. We found a significant positive correlation between homocysteine levels and NOD duration, and hsCRP levels were positively correlated with the apnea-hypopnea index and NOD duration. Conclusions: In all OSAS groups, homocysteine levels were elevated regardless of the presence of cardiac dysfunction. Echocardiographic abnormalities were primarily left-ventricular (LV) hypertrophy and LV diastolic dysfunction and could be observed in all OSAS severity groups. Copyright (C) 2009 S. Karger AG, Basel

Keywords

Author Keywords

C-reactive protein Echocardiography Homocysteine Obstructive sleep apnea syndrome

OBSTRUCTIVE SLEEP APNEA SYNDROME IN GERIATRIC PATIENTS

By

Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1]

 (provided by Clarivate) 

Source

TURKISH JOURNAL OF GERIATRICS-TURK GERIATRI DERGISI

Volume

15

Issue

2

Page

179-187

Published

2012

Indexed

2012-09-19

Document Type

Article

Abstract

Introduction: We aimed to evaluate the obstructive sleep apnea syndrome (OSAS) profile in geriatric OSAS patients and assess the differences between the older and younger OSAS population.

Materials and Method: Seven hundred and six OSAS patients (>= 18 years), 107(15.2%) of whom were in the geriatric group were included in the study. Their demographic, anthropometric, polysomnographic characteristics and comorbidities were compared with the OSAS patients <65 years of age.

Results: Sixty-two (57.9%) of the geriatric patients were male. Mean age was 72 +/- 6years (range:65-89) and apnea-hypopnea index (AHI) was 37.02 +/- 22.46/h. Geriatric patients had significantly higher AHI, lower sleep efficiency, shorter deep sleep and REM periods, longer REM latency, lower basal/minimum/average oxygen saturations and longer <90% oxygen desaturation/apnea/hypopnea durations when compared to the younger age group. In the geriatric group, comorbidities were more frequent than the younger group. When independent risk factors were investigated with regard to comorbidities in OSAS; age, male gender, severity of OSAS and oxygen desaturation duration were found to affect the presence of coronary artery disease.

Conclusion: In geriatric OSAS patients, severe OSAS and comorbidities were more frequent than those <65 years of age. Especially in geriatric patients with coronary artery disease, presence of OSAS should be considered as a factor that affects morbidity and mortality.

Author Keywords

Sleep Apnea, Obstructive Geriatrics Polysomnography Coronary Artery Disease Comorbidity

 SIMULTANEOUS RENAL AND LUNG CANCER

By

Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1] ; Soylu, AC (Soylu, Akin Cem) [1] ; Yurtlu, S (Yurtlu, Sirin) [1]

 (provided by Clarivate) 

Source

TURKISH THORACIC JOURNAL

Volume

13

Issue

1

Page

34-37

DOI

10.5152/ttd.2012.08

Published

MAR 2012

Indexed

2012-03-01

Document Type

Article

Abstract

In the follow up period of extrapulmonary malignancies, detection of a pulmonary nodule should not be always considered as a metastatic lesion. It could also be another simultaneous primary lung malignancy. Determining the etiology of the new lesion is important in order to decide the therapeutic management and prognosis. Simultaneous renal and lung cancer is a rare condition and can usually be detected randomly during scanning for metastases. We present a 75 year-old man with renal cell cancer and coinci dental small cell lung cancer discovered during preoperative evaluation.

Keywords

Author Keywords

Multiple primary tumor synoran tumorlung cancer renal cancer simultaneous tumors

Analysis of obstructive sleep apnea patients with "sawtooth sign" on the flow-volume curve

By

Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1]

 (provided by Clarivate) 

Source

SLEEP AND BREATHING

Volume

15

Issue

3

Page

357-365

DOI

10.1007/s11325-010-0393-9

Published

SEP 2011

Indexed

2011-10-26

Document Type

Article

Abstract

The aims of the present study are to determine whether there is an obstructive sleep apnea (OSA) subgroup presenting with sawtooth sign on the spirometric flow-volume curve, and to identify the clinical importance of the sawtooth sign in these patients.

The study subjects consisted of 134 OSA patients (a parts per thousand yen18 years) whose spirometric tests were made on the same day with the polysomnography. Patients without sawtooth sign were taken as the control group. Patients with sawtooth sign and control subjects were retrospectively analyzed in terms of distinctive demographic, anthropometric, polysomnographic, and spirometric characteristics.

OSA patients with sawtooth sign (n = 36) had greater neck circumference and body weight, and were taller than control subjects (n = 98). Patients with sawtooth sign were mainly males (p < 0.01). Female/male ratios were similar in control subjects. The presence of coronary artery disease was higher (p = 0.024), and current smokers were more (p = 0.014) among the patients with sawtooth sign than control subjects. In logistic regression analysis, the presence of sawtooth sign and age were the only statistically significant parameters (p = 0.028 and p = 0.002, respectively) that affect the likelihood of coronary artery diseases. There were no differences among the groups with regard to age, BMI, wrist circumference, and other comorbid conditions. The duration time of oxygen desaturation (< 90%), avarage, and longest duration of total apnea were longer (p = 0.050, p = 0.034 and p = 0.014, respectively) and the obstructive apnea index was more (p = 0.035) in OSA patients with sawtooth sign when compared to control subjects. There were no differences with regard to other polysomnographic parameters, sleep architecture, Epworth sleepiness score, and spirometric parameters.

As an OSA subgroup, the OSA patients with sawtooth sign may have more frequent and longer duration of obstructive apneas, longer duration time of oxygen desaturation, and greater risk for the coronary artery disease.

Keywords

Author Keywords

Obstructive sleep apnea Sawtooth sign Flow-volume curve  Spirometry Coronary artery disease

The Evolution of Radiological Lesions due to Septic Pulmonary Embolism

By

Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1] ; Soylu, AC (Soylu, Akin Cem) [1]

 (provided by Clarivate) 

Source

TURKISH THORACIC JOURNAL

Volume

12

Issue

1

Page

39-43

DOI

10.5152/ttd.2011.09

Published

MAR 2011

Indexed

2011-03-01

Document Type

Article

Abstract

A 22 year-old female patient presented with septic pulmonary embolism (SPE) due to infective arthritis with demonstrative thorax CT images that provided early diagnosis and showed the evolution of radiological lesions. Thoracic CT revealed multiple nodular lesions and areas of consolidation with various sizes on both lung fields. Some of them were cavitating and some were pleurally based. Methicillin sensitive Staphylococcus aureus was obtained on culture as the etiologic agent. Clinical improvement was observed on the 6th day of treatment and the radiological improvement was achieved within a 2 month period.

Keywords

Author Keywords

Septic pulmonary embolism arthritis radiological findings computed

Miliary Pulmonary Metastases of Malign Pleural Mesothelioma

By

Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1] ; Soylu, AC (Soylu, Akin Cem) [1]

 (provided by Clarivate) 

Source

EURASIAN JOURNAL OF PULMONOLOGY

Volume

13

Issue

1

Page

41-45

DOI

10.5505/solunum.2011.92063

Published

APR 2011

Indexed

2011-04-01

Document Type

Article

Abstract

Malign pleural mesothelioma is characterized as an aggressive tumor that spreads widely on the pleura and invases directly thoracic structures. Miliary metastases are very rare in malignant pleural mesotheliomas. However, they can be observed at the time of diagnosis in some of the cases when the primary lesion is not detected and in some others in the later stages. For this reason one should suspect malignant mesotheliomas in the differential diagnosis when presentation is with diffuse miliary or micronodular pulmonary lesions. Immunehistochemical studies are helpful especially in differential diagnosis of other metastases when the primary lesion is not known. Here, a 58 year-old woman having mixed type malignant pleural mesothelioma is being presented because she had miliary pulmonary metastases revealed in thorax CT at the 9th month of the diagnosis. She was not a smoker and there was no history of asbest exposition. The patient died due to respiratory insufficiency at the 17th month of the diagnosis.

Keywords

Author Keywords

malignant pleural mesothelioma miliary micronodular metastasis pulmonary

Microscopic bilateral posterior cordotomy in severe obstructive sleep apnea syndrome with bilateral vocal cord paralysis

By

Sariman, N (Sariman, Nesrin) [1] , [2] , [4] ; Koca, Ö (Koca, Oncel) [3] ; Boyaci, Z (Boyaci, Zerrin) [3] ; Levent, E (Levent, Ender) [2] ; Soylu, AC (Soylu, Akin Cem) [2] ; Alparslan, S (Alparslan, Sumeyye) [2] ; Saygi, A (Saygi, Attila) [2]

 (provided by Clarivate) 

Source

SLEEP AND BREATHING

Volume

16

Issue

1

Page

17-22

DOI

10.1007/s11325-010-0458-9

Published

MAR 2012

Indexed

2012-03-10

Document Type

Article

Abstract

Vocal cord paralysis is a rare cause of obstructive sleep apnea syndrome (OSAS). Recurrent laryngeal nerve injury after thyroid gland surgery is one of the leading causes of acquired vocal cord paralysis.

A 46-year-old woman with OSAS due to bilateral abductor vocal cord paralysis was presented. She had thyroidectomy 30 years ago and had a weak, breathy voice. She had been referred with a history of high-pitched snoring, apnea witnessed by her spouse, and excessive daytime sleepiness for the last 5 years. Full-night polysomnography revealed that her apnea-hypopnea index was 72/h and minimal oxygen saturation level was 81%. There was no REM and deep sleep periods. Ear-nose-throat consultation offered an endoscopic bilateral posterior cordotomy operation via microscopic suspension laryngoscopy (MLS) as a treatment option.

Instead of using a nasal positive airway pressure (nCPAP) device, she was treated surgically. Her OSAS resolved completely within 5 months of the surgery. Her phonation was preserved, and symptoms such as snoring and hypersomnolance disappeared. In OSAS patients with bilateral vocal cord paralysis, MLS-associated bilateral posterior cordotomy can be a choice of treatment as an alternative to nCPAP application.

Keywords

Author Keywords

Bilateral vocal cord paralysis Vocal cord paralysis Obstructive sleep apnea syndrome Microscopic suspension laryngoscopy Cordotomy

Short-term positive airway pressure therapy response in obstructive sleep apnea patients: impact of treatment on the quality of life

By

Yurtlu, S (Yurtlu, Sirin) [1] ; Sariman, N (Sariman, Nesrin) [1] ; Levent, E (Levent, Ender) [1] ; Soylu, AC (Soylu, Akin Cem) [1] ; Alparslan, S (Alparslan, Sumeyye) [1] ; Saygi, A (Saygi, Attila) [1]

 (provided by Clarivate) 

Source

TUBERKULOZ VE TORAK-TUBERCULOSIS AND THORAX

Volume

60

Issue

4

Page

327-335

DOI

10.5578/tt.4057

Published

2012

Indexed

2012-01-01

Document Type

Article

Abstract

Introduction: We aimed to assess the compliance of obstructive sleep apnea (OSA) patients of whom we planned positive airway pressure (PAP) therapy by using "Calgary Sleep Apnea Quality of Life Index (SAQLI)","Epworth Sleepiness Score (ESS)","OSAS Symptoms Questionnaire (OSQ)" and, to investigate the early effects of treatment on the quality of life.

Patients and Methods: A total of 30 adult (male/female: 23/7) OSA patients who applied to Sleep Research Laboratory at the University Hospital, complaining of symptoms related to sleep and polysomnographically verified as OSAS with PAP therapy indications were included to the study. Their written consent were obtained.

Results: Characteristics of the patients, OSAS symptoms, ESS and SAQLI sores were recorded. After a month, on the second visit, ESS, SAQLI and OSAS symptoms questionnaire had been repeated. All the patients have routinely used PAP devices for a period of a month. PAP therapy provided significant improvements in excessive daytime sleepiness, symptoms questionnaire and SAQLI scores (p< 0.001). There was a significant correlation between apnea hypopnea index (AHI) score and the improvements in emotional functioning (r = -0.374, p= 0.045).

Conclusion: We concluded that the OSA patients can have remarkable benefits from PAP therapy during the early treatment period. This study increased the awareness of the patients about their illness and their perceived benefits related to PAP treatment. Emotional functioning improved prominantly as the disease's severity increased.

Keywords

Author Keywords

Compliance obstructive sleep apnea syndrome positive airway pressure treatment sleep apnea quality of life index

Comparison of the sixth and seventh editions of the TNM staging systems with regard to non-small cell lung carcinoma

By

Düzgün, Y (Duzgun, Yeliz) [3] ; Saygi, A (Saygi, Attila) [1] ; Levent, E (Levent, Ender) [1] ; Yilmaz, HÖ (Yilmaz, Huri Ozkan) [3] ; Köksal, H (Koksal, Hulya) [3] ; Soylu, AC (Soylu, Akin Cem) [1] ; Kutlu, CA (Kutlu, Cemal Asim) [1] , [2]

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Source

TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY

Volume

20

Issue

3

Page

536-543

DOI

10.5606/tgkdc.dergisi.2012.102

Published

JUL 2012

Indexed

2012-09-19

Document Type

Article

Abstract

Background: In this study, we aimed to compare the clinical tumor node metastasis (TNM) and pathological TNM staging of non-small cell lung cancer (NSCLC) using the sixth and seventh editions of the TNM staging and to establish whether there was any concordance between these editions.

Methods: The records of 60 patients (57 males, 3 females; mean age 57 10 years; range 34 to 81 years) who were operated between January 2007 and October 2009 diagnosed with NSCLC in our clinic were retrospectively analyzed. Both clinical (pre-thoracotomy) and pathological (post-thoracotomy) staging were performed separately according to the sixth and seventh editions of the TNM systems.

Results: With the sixth edition, the concordance rate for the clinical and pathological T stage was 73.3% while the concordance rate for the clinical TNM and pathological TNM stage was 48.3%. Twenty percent of the patients were clinically underestimated, and 31.7% were overestimated. The seventh edition of the TNM staging yielded concordance rates of 61.7% for the clinical and pathological T stage and 41.7% for the clinical TNM and pathological TNM stage was 41.7%. With this edition, 28.3% of the patients were clinically underestimated, and 30% were overestimated. Clinical and pathological TNM staging according to seventh edition were similar to the previous stages in 81.7% and 70% of the patients, respectively while understaging was seen in 6.7% and 5.0%, respectively. Overstaging occurred in 11.7% and 25.0% of the patients, respectively.

Conclusion: In our study, the concordance rate for the clinical TNM and pathological TNM stage was lower for the seventh edition of the staging systems than for the sixth editon. This result suggests the importance of invasive staging and systematic lymph node dissection. Based on our samples with early stage, we believe that there should be no change in the treatment for patients with upstaging according to the seventh edition of the staging system.

Keywords

Author Keywords

Classification clinical staging lung cancer staging pathological staging

Bronchoscopic narrow band imaging technique in diagnosis of lung malignancy

By

Yayli, N (Yayli, Nursel) [2] ; Dabak, G (Dabak, Gul) [2] ; Levent, E (Levent, Ender) [1] ; Saygi, A (Saygi, Attila) [1] ; Aksoy, F (Aksoy, Ferda) [3]

 (provided by Clarivate) 

Source

TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY

Volume

20

Issue

4

Page

812-819

DOI

10.5606/tgkdc.dergisi.2012.159

Published

OCT 2012

Indexed

2012-11-28

Document Type

Article

Abstract

Background: In this study, we aimed to investigate the diagnostic value of bronchoscopic narrow-band imaging (NBI) in cancerous, precancerous and recurrent malignant lesions and whether NBI was superior to white light bronchoscopy (WLB). We also evaluated whether the combination of NBI and WLB might contribute to the success of a biopsy.

Methods: Between May 2006 and December 2008, 30 patients (27 males, 3 females; mean age 62 +/- 8 years; range 44 to 82 years) with indication for bronchoscopy, 18 years of age and over were evaluated in this prospective and partially blinded study. The NBI with the bronchoscopy was performed, followed by WLB. A total of 81 biopsy samples were taken from the tissue with normal and abnormal appearance.

Results: The sensitivity of NBI technique was 50.0%, the specificity was 54.9%, the positive predictive value was 39.47% and negative predictive value was 65.12%. The sensitivity of WLB technique was 56.66%, the specificity was 64.71%, the positive predictive value was 48.57% and negative predictive value was 71.74%. The malignancy detection rate of NBI technique was 6.25% in areas with normal findings on WLB.

Conclusion: Our results showed that the use of the NBI technique was not superior to WLB in terms of contribution for the diagnosis in patients with a preliminary diagnosis of lung malignancy.

Keywords

Author Keywords

Bronchoscopy early diagnosis lung cancer narrow band imaging screening

Pneumomediastinum and subcutaneous emphysema without pneumothorax in an asthmatic patient

By

Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1]

 (provided by Clarivate) 

Source

EURASIAN JOURNAL OF PULMONOLOGY

Volume

10

Issue

2

Page

131-135

Published

AUG 2008

Indexed

2008-08-01

Document Type

Article

Abstract

Pneumomediastinum with subcutaneous emphysema is caused by a sustained increase in the alveolar and intrabronchial pressure due to asthmatic bronchospasm, physical activity and excessive coughing or vomiting. Pneumomediastinum should be considered in the differantial diagnosis of chest pain in healthy adolescents and young adults. Chest Xray and computerized tomography (CT) were diagnostic in all cases. A 68-year-old asthmatic male was admitted to our department with sudden onset, severe chest and back pain and dyspnea that developed during excessive coughing. The chest X-ray was normal. CT of the thorax, when performed, revealed the diagnosis of pneumomediastinum and subcutaneous emphysema and a fracture on the 8th rib posteriorly. Interestingly there was neither pneumothorax nor haemothorax.

Keywords

Author Keywords

asthma chest pain pneumomediastinum rib fracture subcutaneous emphysema

Repetitive Endoscopic Laser Treatments for Palliation of Lung Malignancies

By

Karaagac, G (Karaagac, Guler) [1] ; Levent, E (Levent, Ender) [1] ; Sariman, N (Sariman, Nesrin) [1] ; Simsek, S (Simsek, Selcuk) [2] ; Güney, S (Guney, Sefik) [3] ; Karakoca, Y (Karakoca, Yalcin) [1]

 (provided by Clarivate) 

Source

JOURNAL OF BRONCHOLOGY & INTERVENTIONAL PULMONOLOGY

Volume

12

Issue

1

Page

20-22

DOI

10.1097/00128594-200501000-00006

Published

JAN 2005

Indexed

2005-01-01

Document Type

Article

Abstract

Endobronchial laser therapy is generally safe and well tolerated. Because the laser is a form of nonionizing radiation, therapy can be repeated as often as needed. Two male patients, 50 and 55 years old, were referred to our clinic because of severe dyspnea and massive hemoptysis, the first 3 years ago and the second 1.5 years ago. In his medical history, the former patient had a thoracotomy for thymoma resection 5 years ago. Rigid bronchoscopy was performed under general anesthesia, Nd:YAP (neodymium-yttrium, aluminum, pevroskite) laser resection and silicon stent insertion were carried out for an endobronchial mass that was almost completely obliterating the left main bronchus. During the next 2 years, the same procedure was repeated 6 times to prevent distal tracheal obliteration. The left lung has now been totally collapsed for 2 years and the patient is still alive and healthy. The latter was a patient with a centrally located nonsmall cell lung cancer invading the middle and lower trachea, right main and upper lobe bronchi causing near-total obstruction. Rigid bronchoscopy was performed under general anesthesia. Nd: YAP laser coagulation and mechanical resection were carried out and a Dumon "Y'' stent was inserted. In 1.5 years, therapeutic bronchoscopy was repeated 6 times. The patient is alive without dyspnea or respiratory insufficiency, although with brain metastases. Endoscopic laser resection of lung malignancies is rapid, effective, repeatable, and complementary to other treatments; although it should be considered only palliative, it could be curative in benign lesions and early cancers.

Keywords

Author Keywords

Nd: YAP laser therapeutic bronchoscopy endobronchial obliteration lung malignancy repetitive