Kürşat Uzun

Association of Serum Reactive Oxygen Metabolite Levels with Different Histopathological Types of Lung Cancer

Background: Oxygen is required for respiration and the energetic processes that enable aerobic life. Costs associated with oxygen use are free radical and reactive oxygen metabolite (ROM) formations, which create oxidative stress and contribute to various processes including aging, degenerative diseases and cancer. Additionally, they may have a role in the pathogenesis of lung cancer with different histopathological types. Objectives: In this study, we aimed to investigate the degree of oxidative stress in different types of carcinoma such as small cell carcinoma and non-small cell carcinoma, including epidermoid carcinoma and adenocarcinoma, and to find out whether the degree of oxidative stress shows any difference among them and whether it can be used as an index for their differential diagnosis. Methods: Thirty-eight patients with lung cancer and 26 healthy persons were included in the study. Of the patients with lung cancer, 14 had epidermoid carcinoma, 12 adenocarcinoma and 12 small cell carcinoma. Serum ROM levels were detected by using an available commercial kit according to the manufacturer’s instructions. Results:The ROM levels were significantly lower in the controls than in the patients (p<0.001). Although all subtypes had significantly high ROM levels compared with the controls, the highest significance was found in the small cell carcinoma (p<0.001), and then in the adenocarcinoma and epidermoid carcinoma (p<0.01 and p<0.01, respectively). Conclusions: In the light of these data, it might be possible to conclude that the serum ROM levels increase in patients with different types of lung cancers and may be an index parameter for lung cancer. It could be thought that this increase, particularly in small cell carcinoma, may contribute to its poor progression.

Detection and quantification of the parenchymal abnormalities in emphysema using pulmo-CT.

We aimed to determine the degree and extent of parenchymal abnormalities on pulmo-CT in patients with emphysema. The study group consisted of 29 patients (18 male, 11 female; mean age 57.9+/-13). The diagnosis was based on clinical symptoms, pulmonary function tests (PFT) values, and chest CT findings. All of the patients CT scans were obtained during suspended deep inspiration from the apices to the costophrenic angles. The mean lung attenuation (MLD) and parenchymal abnormalities related to emphysema were quantitatively calculated with tables, histograms and graphics at the whole lung. The lung density measurements revealed a mean density of -898.48+/-51.37 HU in patients with emphysema and -825.1+/-25.5 HU in control group. In addition, mean percentage of subthreshold attenuation values was found as 12.03+/-15.75 and 1.07+/-0.83 in patients with emphysema and control group, respectively. Compared with control group, the patients with emphysema had a significantly lower inspiratory MLD (p<0.05). Additionally, statistically significant correlations were seen between the MLD and percentage of subthreshold values (r=0.44, p<0.05). In contrast, there was poor correlation between PFT measurements and the subthreshold values. In conclusion, pulmo-CT is a quick, simple method for quantitative confirmation of the presence of parenchymal abnormalities of lung as mosaic attenuation and should be used in combination with other radiological methods and PFT as it gives additional information to routine examinations in patients with emphysema.

Pulmonary Embolism Originating from a Hepatic Hydatid Cyst Ruptured into the Inferior Vena Cava: CT and MRI Findings

Pulmonary embolism due to hydatid cysts is a very rare clinical entity. Hydatid pulmonary embolism can be distinguished from other causes of pulmonary embolism with contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI). MRI especially displays the cystic nature of lesions better than CECT. Here we report a 45-year-old male patient with the pulmonary embolism due to ruptured hydatid liver cyst into the inferior vena cava.

Invasive and Noninvasive Mechanical Ventilation Strategies in Asthma

Astımlı hastaların çoğunda atak kontrolü kolayca elde edilir. Ancak, küçük bir kısmında astım ölümcül olabilir. Ancak, solunum yetmezliği gelişen astımlı hastalarda noninvaziv veya invaziv ventilasyon genellikle gerekli olabilmektedir. Astımlı hastada invaziv mekanik ventilasyon yoğun bakım ekibine zorluklar yaşatabilmekte ve sıklıkla permisif hiperkapni, derin sedasyon ve nöromüsküler blokaja gereklilik göstermektedir. Bu koruyucu yaklaşımlara rağmen, mekanik ventilasyon astımlı hastalarda yüksek komplikasyonlara neden olmaktadır. Bu nedenle astımlı hastalarda invaziv mekanik ventilasyon tercihi son çare olmalıdır. Astımlı hastalarda noninvaziv mekanik ventilasyon (NIV) kullanımı orotrakeal entübasyon ve mekanik ventilasyon ile ilişkili komplikasyonları azaltabilir. Birkaç çalışma astım ataklarında NIV kullanımını araştırmıştır. Ancak, sınırlı miktardaki verilere göre NIV akut astımda yararlı olabileceğini düşündürmektedir. Bu derlemede, astımda solunum yetmezliği mekanizmalarını ve önerilere göre astımda mekanik ventilasyon için tavsiyeleri değerlendirdik.