Tuberculous lymphadenitis without pulmonary manifestation is an uncommon entity in developed coun... more Tuberculous lymphadenitis without pulmonary manifestation is an uncommon entity in developed countries, and the possibility of tuberculous infection is usually ignored in the differential diagnosis of lymphadenopathy. Therefore, appropriate treatment may be delayed. Paralysis of the recurrent laryngeal nerve caused by mediastinal lymphadenopathy due to tuberculosis is an extremely rare condition. In this paper, we present a patient who had vocal cord paralysis caused by tuberculous lymphadenopathy of the superior mediastinum. After anti-tuberculosis treatment, vocal cord function was only partially recovered, while the clinical, radiological, and laboratory abnormalities were completely recovered.
... The accuracy, sensitivity and specificity of the Acc-S<800 cm/sec2 for demonstrati... more ... The accuracy, sensitivity and specificity of the Acc-S<800 cm/sec2 for demonstrating low LAA emptying velocity (<45 cm/sec) were 96 ... view), surface (LAs), volume (LAv) and ejection fraction (LA EF), right atrial dimensions (RAd) and surface (RAs), total atrial surface (TAs), as the ...
... Dr. Leyla MEMIS from Gazi University, Ankara, Turkey for their valuable contributions. ... In... more ... Dr. Leyla MEMIS from Gazi University, Ankara, Turkey for their valuable contributions. ... Int Immunopharmacol 2, 173182 (2002) 3) C Sevinc, AH Cimrin, M Manisali, E Yalcin and YAlkan: Sandblasting under uncontrolled and primitive conditions in Turkey. ...
The aim of this study was to investigate the relation of HLA alleles in patients with non-small c... more The aim of this study was to investigate the relation of HLA alleles in patients with non-small cell lung cancer (NSCLC). The incidence of class I and II HLA alleles of 63 patients with NSCLC were prospectively compared with the incidence of class I and II HLA alleles with 88 healthy controls. The number of cases with stage I and II (early stage) was 12 and there were 51 cases with stage III and IV (advanced stage). Metastasis rates of the regional lymph node in patients were as follow; N(0): n=10; N(1): n=13; N(2): n=26 and N(3): n=14. Lymph node metastasis was detected by pathological staging in 15 cases and by clinical staging in 48 cases. Lymph node metastasis was searched in all patients by a helical thorax CT. All distant metastasis were investigated by thorax CT, abdominal CT, brain CT or MRI and bone scintigraphy, and distant organ metastasis was detected in 25 cases. The patients and healthy controls were typed for HLA class I and II alleles. HLA-A2 was an independent risk factor for both critical lymph node (N(2 and 3)) involvement and distant metastasis. HLA-B44, -CW6 and -CW7 frequencies appear to be significant in controls compared to patients. HLA-A2 frequency was higher in patients with advanced stage than early stage, while HLA-A26, -B35 and -CW4 frequencies were more expressed in patients with early stage than in patients with advanced stage. Compared with controls, frequency of HLA-DRB1*07, -DQ02 and -DQ07 were lower expressed in patients. Compared patients with advanced stage, HLA-DRB1*07 was higher in patients with early stage. HLA-A2 was an independent risk factor for lymph node and distant metastasis, and the allele was significantly higher in patients with critical lymph node for surgery and distant metastasis. HLA-A26 appeared to be a significance protective allele against to metastases.
A Am ma aç ç:: Karbon monoksit (CO) zehirlenmesi flofben ve soba kullan›m›na bal› olarak bölgemiz... more A Am ma aç ç:: Karbon monoksit (CO) zehirlenmesi flofben ve soba kullan›m›na bal› olarak bölgemizde önemli bir sal›k problemi olup, kan›n oksi- jen tafl›ma kapasitesini azaltarak ölümlere sebep olmas›n›n yan› s›ra vücutta önemli patolojilere yol açmaktad›r. Bu çal›flma, CO zehirlen- mesi ile baflvuran hastalarda miyokardiyal hasar›n olup olmad›¤›n›n araflt›r›lmas› için planland›. Y Yö ön nt te em mlle er r:: Çal›flmaya, prospektif olarak, 30'u kad›n 10'u erkek toplam 40 hasta dahil edildi. Hastalar›n yafllar› 15 ile 56 (ortalama yafl: 28.5 ± 9.96 y›l) aras›nda deiflmekte idi. Hastalar›n demografik verileri, vital bulgular›, CO gaz›n›n kayna¤›, koroner arter hastal›¤›n›n (KAH) risk faktörleri ve sigara içip içmedikleri kaydedildi. Tüm hastalarda Glasgow koma skoru deerlendirmesi, elektrokardiyografi (EKG), periferik arteryel kan gaz› analizi, tam kan say›m›, kreatin kinaz (CK), kreatin kinaz miyokard band› (CK-MB) ve troponin-T ölçümleri ve bunlara ilaveten karboksihemoglobin (COHb) seviyesi %50'nin üzerinde olan üç hastada da miyokard perfüzyon SPECT çal›flmas› yap›ld›. B Bu ullg gu ulla ar r:: Hastalar›n 9 tanesinde ritm bozukluu olarak sinüs taflikardisi, bir hastada da ventriküler erken vurular tespit edildi ve troponin- T pozitif kaydedildi. Alt› hastada CK, CK-MB düzeyleri anlaml› derecede yüksek bulunmakla birlikte, bu hastalardaki troponin-T ölçümleri normal idi. Yüksek troponin-T seviyesi (0.13 ng/ml) COHb seviyesi %61.3 olan yaln›zca bir vakada tespit edildi. COHb seviyeleri %50'nin üzerinde olan üç olguda miyokardiyal SPECT çal›flmas› yap›ld›, ancak defekt ile uyumlu bulgu saptanmad›. S So on nu uç ç:: Sonuç olarak, bu çal›flma CO zehirlenmelerinde zeminde bilinen KAH olmayan hastalarda %60'l›k COHb düzeylerine kadar olan zehirlenmelerde önemli derecede miyokardiyal hasar ve hayat› tehdit eden kardiyak hemodinamik bozukluk ve disritmi geliflmediini göstermektedir. Bu çal›flman›n sonucu bilinen KAH olmayan ve iskemik kardiyak semptom ve EKG bulgular›n›n efllik etmedii CO zehirlen- meli hastalarda miyokardiyal hasar göstergesi olarak miyokardiyal enzimlerin (Troponin T, CK ve CK-MB ) ve miyokard perfüzyon SPECT çal›flmas›n›n rutin kullan›m›na gerek olmad›¤›n› düflündürmektedir. (Anadolu Kardiyol Derg 2005; 5: 189-93) ABSTRACT Orijinal Arafltirma Original Investigation
Systemic corticosteroids are strongly recommended in the treatment of exacerbations of chronic ob... more Systemic corticosteroids are strongly recommended in the treatment of exacerbations of chronic obstructive pulmonary disease (COPD). As COPD patients are usually elderly and are relatively immobile, side effects of systemic corticosteroids frequently outweigh their beneficial effects. On the contrary, nebulized corticosteroid solutions have a negligible systemic side-effect profile. In this review, as an alternative to systemic corticosteroids, the place of nebulized corticosteroids in exacerbation periods of COPD was summarized. The number of trials in the literature is increasing. Regarding the available data, high dose nebulized budesonide was found as effective as systemic corticosteroids in exacerbations of COPD. The side-effect profile, blood glucose level in particular, is better for nebulized budesonide. Findings from recent studies are giving a positive impression on the role of high dose nebulized budesonide in exacerbations of COPD. However, larger and statistically high powered trials testing different types of nebulized corticosteroid solutions with varying dosages are still lacking. Before recommending the routine use of nebulized corticosteroids in exacerbations, present findings need to be confirmed with further studies of high quality.
Aim: Although liver injury due to cardiac, chronic respiratory and circulatory failure has been ... more Aim: Although liver injury due to cardiac, chronic respiratory and circulatory failure has been reported, this has yet to be studied in patients with pulmonary embolism (PE). We investigated liver injury in patients with acute PE.Methods: We retrospectively reviewed 107 acute PE patients over a two-year period. Patients were categorized as having: (1) severe (PaO2 < 45 mmHg), moderate (45 mmHg ≤ PaO2≤ 60 mmHg) or mild hypoxemia (60 mmHg < PaO2 < 80 mmHg) groups; (2) massive and non-massive PE; (3) absence or presence of pre-existing cardiopulmonary disease; and (4) absence or presence of right ventricle dysfunction. Serum levels of liver enzymes were compared between groups.Results: Transaminase levels were higher in severe hypoxemia patients compared mild hypoxemia patients (p=0.045 and p=0.036). Albumin and bilirubin levels were lower and higher, respectively, in patients with severe and moderate hypoxemia compared to mild hypoxemia patients (p < 0.05 and p < 0.01). There was a negative correlation between hepatic markers and PaO2 and %SaO2: r=–0.212, p=0.032 between AST and %SaO2; r=–0.243, p=0.013 and r=–0.241, p=0.014 between ALT and PaO2 and %SaO2; and r=–0.224, p=0.024 and r= –0.283, p=0.004 between direct bilirubin and PaO2 and %SaO2. AST and ALT levels were higher in massive PE than non-massive PE patients (p=0.0001). Albumin levels were lower in patients with right ventricle dysfunction than in those without (p=0.02). One (0.9%) had a clinical picture of hypoxic hepatitis.Conclusion: Abnormal LFTs showed a mixed pattern in patients with acute PE.
Objective: The aim of the present study was to document the serum IL-18 levels in patients with ... more Objective: The aim of the present study was to document the serum IL-18 levels in patients with pulmonary tuberculosis (P-TB), extrapulmonary tuberculosis (EP-TB), pneumonia, lung cancer and in healthy controls, and to investigate whether it may assist in the differential diagnosis of P-TB.Methodology: A total of 116 patients were included in the study. The study population consisted of patients with P-TB, EP-TB, pneumonia and lung cancer and controls. P-TB patients were graded according to sputum positivity and extent of disease. Serum levels of IL-18 (ELISA) were compared between groups and with other clinical measures of disease.Results: Compared with the controls, all groups of patients had increased serum levels of IL-18. The highest mean concentration of IL-18 was observed in P-TB. Serum levels of IL-18 in the patients with P-TB correlated well with the extent of disease.Conclusions: Although increased serum levels of IL-18 were not specific for TB, the increased levels may favour active TB in radiologically advanced disease where CXR findings are difficult to interpret, and sputum smears or cultures are not helpful.
... Hasan KAYNAR1, Nusret YILMAZ1, Leyla SAĞLAM1, Mehmet MERAL1, Ülkü ALTOPARLAK2, Metin GÖRGÜNER... more ... Hasan KAYNAR1, Nusret YILMAZ1, Leyla SAĞLAM1, Mehmet MERAL1, Ülkü ALTOPARLAK2, Metin GÖRGÜNER1, Arzu MİRİCİ1 ... Aynı bronş içerisinden steril lavaj yapılarak elde edilen materyal ile birlikte zaman kaybetmeden mikrobiyoloji laboratuvarına gön-derildi. ...
Tuberculous lymphadenitis without pulmonary manifestation is an uncommon entity in developed coun... more Tuberculous lymphadenitis without pulmonary manifestation is an uncommon entity in developed countries, and the possibility of tuberculous infection is usually ignored in the differential diagnosis of lymphadenopathy. Therefore, appropriate treatment may be delayed. Paralysis of the recurrent laryngeal nerve caused by mediastinal lymphadenopathy due to tuberculosis is an extremely rare condition. In this paper, we present a patient who had vocal cord paralysis caused by tuberculous lymphadenopathy of the superior mediastinum. After anti-tuberculosis treatment, vocal cord function was only partially recovered, while the clinical, radiological, and laboratory abnormalities were completely recovered.
... The accuracy, sensitivity and specificity of the Acc-S&amp;lt;800 cm/sec2 for demonstrati... more ... The accuracy, sensitivity and specificity of the Acc-S&amp;lt;800 cm/sec2 for demonstrating low LAA emptying velocity (&amp;lt;45 cm/sec) were 96 ... view), surface (LAs), volume (LAv) and ejection fraction (LA EF), right atrial dimensions (RAd) and surface (RAs), total atrial surface (TAs), as the ...
... Dr. Leyla MEMIS from Gazi University, Ankara, Turkey for their valuable contributions. ... In... more ... Dr. Leyla MEMIS from Gazi University, Ankara, Turkey for their valuable contributions. ... Int Immunopharmacol 2, 173182 (2002) 3) C Sevinc, AH Cimrin, M Manisali, E Yalcin and YAlkan: Sandblasting under uncontrolled and primitive conditions in Turkey. ...
The aim of this study was to investigate the relation of HLA alleles in patients with non-small c... more The aim of this study was to investigate the relation of HLA alleles in patients with non-small cell lung cancer (NSCLC). The incidence of class I and II HLA alleles of 63 patients with NSCLC were prospectively compared with the incidence of class I and II HLA alleles with 88 healthy controls. The number of cases with stage I and II (early stage) was 12 and there were 51 cases with stage III and IV (advanced stage). Metastasis rates of the regional lymph node in patients were as follow; N(0): n=10; N(1): n=13; N(2): n=26 and N(3): n=14. Lymph node metastasis was detected by pathological staging in 15 cases and by clinical staging in 48 cases. Lymph node metastasis was searched in all patients by a helical thorax CT. All distant metastasis were investigated by thorax CT, abdominal CT, brain CT or MRI and bone scintigraphy, and distant organ metastasis was detected in 25 cases. The patients and healthy controls were typed for HLA class I and II alleles. HLA-A2 was an independent risk factor for both critical lymph node (N(2 and 3)) involvement and distant metastasis. HLA-B44, -CW6 and -CW7 frequencies appear to be significant in controls compared to patients. HLA-A2 frequency was higher in patients with advanced stage than early stage, while HLA-A26, -B35 and -CW4 frequencies were more expressed in patients with early stage than in patients with advanced stage. Compared with controls, frequency of HLA-DRB1*07, -DQ02 and -DQ07 were lower expressed in patients. Compared patients with advanced stage, HLA-DRB1*07 was higher in patients with early stage. HLA-A2 was an independent risk factor for lymph node and distant metastasis, and the allele was significantly higher in patients with critical lymph node for surgery and distant metastasis. HLA-A26 appeared to be a significance protective allele against to metastases.
A Am ma aç ç:: Karbon monoksit (CO) zehirlenmesi flofben ve soba kullan›m›na bal› olarak bölgemiz... more A Am ma aç ç:: Karbon monoksit (CO) zehirlenmesi flofben ve soba kullan›m›na bal› olarak bölgemizde önemli bir sal›k problemi olup, kan›n oksi- jen tafl›ma kapasitesini azaltarak ölümlere sebep olmas›n›n yan› s›ra vücutta önemli patolojilere yol açmaktad›r. Bu çal›flma, CO zehirlen- mesi ile baflvuran hastalarda miyokardiyal hasar›n olup olmad›¤›n›n araflt›r›lmas› için planland›. Y Yö ön nt te em mlle er r:: Çal›flmaya, prospektif olarak, 30'u kad›n 10'u erkek toplam 40 hasta dahil edildi. Hastalar›n yafllar› 15 ile 56 (ortalama yafl: 28.5 ± 9.96 y›l) aras›nda deiflmekte idi. Hastalar›n demografik verileri, vital bulgular›, CO gaz›n›n kayna¤›, koroner arter hastal›¤›n›n (KAH) risk faktörleri ve sigara içip içmedikleri kaydedildi. Tüm hastalarda Glasgow koma skoru deerlendirmesi, elektrokardiyografi (EKG), periferik arteryel kan gaz› analizi, tam kan say›m›, kreatin kinaz (CK), kreatin kinaz miyokard band› (CK-MB) ve troponin-T ölçümleri ve bunlara ilaveten karboksihemoglobin (COHb) seviyesi %50'nin üzerinde olan üç hastada da miyokard perfüzyon SPECT çal›flmas› yap›ld›. B Bu ullg gu ulla ar r:: Hastalar›n 9 tanesinde ritm bozukluu olarak sinüs taflikardisi, bir hastada da ventriküler erken vurular tespit edildi ve troponin- T pozitif kaydedildi. Alt› hastada CK, CK-MB düzeyleri anlaml› derecede yüksek bulunmakla birlikte, bu hastalardaki troponin-T ölçümleri normal idi. Yüksek troponin-T seviyesi (0.13 ng/ml) COHb seviyesi %61.3 olan yaln›zca bir vakada tespit edildi. COHb seviyeleri %50'nin üzerinde olan üç olguda miyokardiyal SPECT çal›flmas› yap›ld›, ancak defekt ile uyumlu bulgu saptanmad›. S So on nu uç ç:: Sonuç olarak, bu çal›flma CO zehirlenmelerinde zeminde bilinen KAH olmayan hastalarda %60'l›k COHb düzeylerine kadar olan zehirlenmelerde önemli derecede miyokardiyal hasar ve hayat› tehdit eden kardiyak hemodinamik bozukluk ve disritmi geliflmediini göstermektedir. Bu çal›flman›n sonucu bilinen KAH olmayan ve iskemik kardiyak semptom ve EKG bulgular›n›n efllik etmedii CO zehirlen- meli hastalarda miyokardiyal hasar göstergesi olarak miyokardiyal enzimlerin (Troponin T, CK ve CK-MB ) ve miyokard perfüzyon SPECT çal›flmas›n›n rutin kullan›m›na gerek olmad›¤›n› düflündürmektedir. (Anadolu Kardiyol Derg 2005; 5: 189-93) ABSTRACT Orijinal Arafltirma Original Investigation
Systemic corticosteroids are strongly recommended in the treatment of exacerbations of chronic ob... more Systemic corticosteroids are strongly recommended in the treatment of exacerbations of chronic obstructive pulmonary disease (COPD). As COPD patients are usually elderly and are relatively immobile, side effects of systemic corticosteroids frequently outweigh their beneficial effects. On the contrary, nebulized corticosteroid solutions have a negligible systemic side-effect profile. In this review, as an alternative to systemic corticosteroids, the place of nebulized corticosteroids in exacerbation periods of COPD was summarized. The number of trials in the literature is increasing. Regarding the available data, high dose nebulized budesonide was found as effective as systemic corticosteroids in exacerbations of COPD. The side-effect profile, blood glucose level in particular, is better for nebulized budesonide. Findings from recent studies are giving a positive impression on the role of high dose nebulized budesonide in exacerbations of COPD. However, larger and statistically high powered trials testing different types of nebulized corticosteroid solutions with varying dosages are still lacking. Before recommending the routine use of nebulized corticosteroids in exacerbations, present findings need to be confirmed with further studies of high quality.
Aim: Although liver injury due to cardiac, chronic respiratory and circulatory failure has been ... more Aim: Although liver injury due to cardiac, chronic respiratory and circulatory failure has been reported, this has yet to be studied in patients with pulmonary embolism (PE). We investigated liver injury in patients with acute PE.Methods: We retrospectively reviewed 107 acute PE patients over a two-year period. Patients were categorized as having: (1) severe (PaO2 < 45 mmHg), moderate (45 mmHg ≤ PaO2≤ 60 mmHg) or mild hypoxemia (60 mmHg < PaO2 < 80 mmHg) groups; (2) massive and non-massive PE; (3) absence or presence of pre-existing cardiopulmonary disease; and (4) absence or presence of right ventricle dysfunction. Serum levels of liver enzymes were compared between groups.Results: Transaminase levels were higher in severe hypoxemia patients compared mild hypoxemia patients (p=0.045 and p=0.036). Albumin and bilirubin levels were lower and higher, respectively, in patients with severe and moderate hypoxemia compared to mild hypoxemia patients (p < 0.05 and p < 0.01). There was a negative correlation between hepatic markers and PaO2 and %SaO2: r=–0.212, p=0.032 between AST and %SaO2; r=–0.243, p=0.013 and r=–0.241, p=0.014 between ALT and PaO2 and %SaO2; and r=–0.224, p=0.024 and r= –0.283, p=0.004 between direct bilirubin and PaO2 and %SaO2. AST and ALT levels were higher in massive PE than non-massive PE patients (p=0.0001). Albumin levels were lower in patients with right ventricle dysfunction than in those without (p=0.02). One (0.9%) had a clinical picture of hypoxic hepatitis.Conclusion: Abnormal LFTs showed a mixed pattern in patients with acute PE.
Objective: The aim of the present study was to document the serum IL-18 levels in patients with ... more Objective: The aim of the present study was to document the serum IL-18 levels in patients with pulmonary tuberculosis (P-TB), extrapulmonary tuberculosis (EP-TB), pneumonia, lung cancer and in healthy controls, and to investigate whether it may assist in the differential diagnosis of P-TB.Methodology: A total of 116 patients were included in the study. The study population consisted of patients with P-TB, EP-TB, pneumonia and lung cancer and controls. P-TB patients were graded according to sputum positivity and extent of disease. Serum levels of IL-18 (ELISA) were compared between groups and with other clinical measures of disease.Results: Compared with the controls, all groups of patients had increased serum levels of IL-18. The highest mean concentration of IL-18 was observed in P-TB. Serum levels of IL-18 in the patients with P-TB correlated well with the extent of disease.Conclusions: Although increased serum levels of IL-18 were not specific for TB, the increased levels may favour active TB in radiologically advanced disease where CXR findings are difficult to interpret, and sputum smears or cultures are not helpful.
... Hasan KAYNAR1, Nusret YILMAZ1, Leyla SAĞLAM1, Mehmet MERAL1, Ülkü ALTOPARLAK2, Metin GÖRGÜNER... more ... Hasan KAYNAR1, Nusret YILMAZ1, Leyla SAĞLAM1, Mehmet MERAL1, Ülkü ALTOPARLAK2, Metin GÖRGÜNER1, Arzu MİRİCİ1 ... Aynı bronş içerisinden steril lavaj yapılarak elde edilen materyal ile birlikte zaman kaybetmeden mikrobiyoloji laboratuvarına gön-derildi. ...
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