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Öğe Clinical and demographic characteristics of tracheobronchial variations(Medknow Publications & Media Pvt Ltd, 2011) Abakay, Abdurrahman; Tanrikulu, Abdullah C.; Sen, Hadice Selimoglu; Abakay, Ozlem; Aydin, Ayse; Carkanat, Ali I.; Senyigit, AbdurrahmanBackground: There are various anatomic variations in tracheobronchial system (tracheal bronchus, ectopic bronchus, and accessory bronchus). We aimed to investigate the bronchoscopic findings of the patients with tracheobronchial variations (TBVs) during bronchoscopy and to describe their clinical characteristics. Materials and Methods: A total of 3322 records of bronchoscopic examinations in university hospital and 1560 in chest disease hospital total 4882 were retrospectively analyzed and 198 (134 male, 64 female) patients were diagnosed as TBV. Results: Mean age of patients was 48.5 +/- 17.8 (range, 15-78) years. Most of the tracheobronchial variations (n = 68, 33.1%) were localized at the right upper lobe bronchus. The most common type of TBVs at this region was right upper lobe with two segments. Symptoms were found in 21 (10.2%) patients with TBVs (7 accessory cardiac bronchus, 5 tracheal bronchus, 5 accessory segmental bronchus in left main bronchus and 4 accessory segmental bronchus in right main bronchus). Their symptoms cough, hemoptysis and recurrent pneumonia with unknown etiologies were thought as related to TBVs. No other potential causes leading these symptoms were found in these patients. Conclusion: According to our best of knowledge our study population is one of the largest series of bronchoscopy for investigate of TBVs. Although TBVs were usually reported as asymptomatic, nearly 10% of our patients with TBVs had symptoms such as recurrent pneumonia, cough and hemoptysis. TBVs should be taken into consideration in symptomatic patients before fiber-optic bronchoscopic examination.Öğe Clinical Characteristics of Patients with Mesothelioma: A University Hospital of 2011 Data(Derman Medical Publ, 2013) Tanrikulu, Abdullah Cetin; Abakay, Abdurrahman; Abakay, Ozlem; Sezgi, Cengizhan; Sen, Hadice Selimoglu; Onder, Omer Faruk; Senyigit, AbdurrahmanAim: Malignant mesothelioma (MM) in the etiology of environmental and occupational asbestos exposure is usually to be responsible. The fibrous zeolite erionite was accused. MM due to environmental asbestos exposure is a common disease in our region. Material and Method: University Hospital in 2011 followed up a total of 28 patients with MM was evaluated retrospectively. Clinical radiological and histopathological features were investigated. Results: Fifteen patients were female and thirteen male. The mean age was 59.9 +/- 12.4 (36-81) years. In nine patients Ergani four patients Cermik district appealed. Fifteen patients (53.6%) were positive for asbestos exposure and mean asbestos exposure time was 24.7 years. Fourteen patients (50%) were diagnosed biopsy. In twelve patients left sides were involved. Seventeen patients had epithelial type. Pleural fluid cytology was positive in only four patients. The most frequent clinical symptom dyspnea. Patients with alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) values were higher. Discussion: People living in dense region are the theme of environmental asbestos MM appropriate should be considered in patients with symptoms and signs. For the prevention of disease in our region for the abandonment of the use of asbestos in environmental studies will be useful to do.Öğe Co-existince of sickle cell disease and hemidiaphragm paralysis(Turkish Assoc Tuberculosis & Thorax, 2006) Babayigit, Cenk; Melek, Ismet Murat; Duman, Taskin; Senyigit, Abdurrahman; Gali, EdipSickle cell anemia is a disease caused by production of abnormal hemoglobin. Infection, acute splenic sequestration crisis, aplastic crises, acute chest syndrome, stroke, cholelithiasis, renal disease and pain are the major complications. Unilateral or bilateral diaphragm paralysis maybe seen following phrenic nerve injury and with a variety of motor-neuron diseases, myelopathies, neuropathies, and myopathies. Prominent right hemi-diaphragma elevation was observed on chest radiograph of a 14 years' old female patient with sickle cell disease. Her medical history yielded neither trauma nor intra-thorasic surgery. She didn't have either motor deficit or sensation disorder on any region of her body. Thorax CT yielded no lession except the significantly elevated right diaphragma. Her cranial CT showed no lesion, too. Diagnosis of right hemidiaphragm paralysis was confirmed by positive Hitzenberg Sniff test on fluoroscopy. Although several pathophysiologic mechanisms are known to be involved and lead to central neurologic complications in sickle cell disease, involvement of peripheric nerves have not been reported. Here we present a 14 years' old female patient with sickle cell anemia and unilateral diaphragm paralysis, co-existince of which have not been reported so far.Öğe Determination of environmental exposure to asbestos (tremolite) and mesothelioma risks in the southeastern region of Turkey(Heldref Publications, 2004) Senyigit, Abdurrahman; Dalgic, Abdurrahman; Kavak, Orhan; Tanrikulu, Abdullah CetinIn this study, the authors examined the concentrations and mineralogical analyses of asbestos, and investigated mesothelioma risk in southeastern Anatolia, Turkey. They used a gravimetric dust sampler to collect samples from 2 villages and 2 asbestos mines (1 active). Samples were then evaluated by an X-ray diffractometer and an electron microscope. The authors found high concentrations of asbestos in an active mine (4.9 fibers[f]/cm(3)) and at a house that was plastered with asbestos (1.24 f/cm(3)) and had a very active population. They found a low concentration (0.0042 f/cm(3)) in indoor measurements taken in Armutova village, and an even lower concentration (0.000081 f/cm(3)) in the inactive mine environment. Outdoor measurements included a low concentration of 0.007 f/cm(3) in the village environment, and a high concentration of 1.17 f/cm(3) on the mine road during the passing of a sheep herd. The people in the region are continuously exposed to asbestos during normal activities. This cumulative exposure to asbestos carries sufficient risks for mesothelioma development.Öğe Elevated Troponin Levels in Acute Exacerbation of COPD(Emergency Medicine Physicians Assoc Turkey, 2013) Erdogan, Mehmet Ozgr; Guloglu, Cahfer; Orak, Murat; Ustundag, Mehmet; Senyigit, AbdurrahmanObjective: To investigate the correlation between serum troponin elevation and vital signs, arterial blood gases, length of stay, prognosis in patients admitted to the emergency department with an exacerbation of chronic obstructive pulmonary disease. Material and Methods: This prospective study was performed on 100 COPD patients admitted to the Dicle University Hospital Emergency Department between January 2008 and June 2008. Ki square test was used for univariate analyses of categorical variables, Mann-Whitney U Test was used for continuous variables. Results: In our study, 11% of patients were in the elevated sTnI group. Elevation of sTnI had no statistical relation with vital signs, electrocardiographic datas or arterial blood gases. Elevation of sTnI had no statistical relation with length of stay (p=0.863), ICU admission (p=0.619) or mortality (p=0.061). Conclusion: High sTnI in COPD patients has no predictive value for length of stay, ICU admission and prognosis.Öğe Migration of ventriculoperitoneal shunt into the lung by passing through the liver and the diaphragm(Aves, 2009) Nazaroglu, Hasan; Ozkan, Umit; Ozmen, Cihan Akgul; Akay, Hatice Ozturkmen; Senyigit, AbdurrahmanThoracic complications are rare after shunt placement for drainage of cerebrospinal fluid to treat hydrocephalus. We report a case of a ventriculoperitoneal shunt catheter that migrated into the lung by passing through the liver and the diaphragm. To our knowledge, there is no previously published report of a ventriculoperitoneal shunt that has migrated into the lung by a transdiaphragmatic and transhepatic route.Öğe Mutations in SLC34A2 cause pulmonary alveolar microlithiasis and are possibly associated with testicular microlithiasis(Cell Press, 2006) Corut, Ayse; Senyigit, Abdurrahman; Ugur, Sibel Aylin; Altin, Sedat; Ozcelik, Ugur; Calisir, Haluk; Yildirim, ZekiPulmonary alveolar microlithiasis (PAM) is a rare disease characterized by the deposition of calcium phosphate microliths throughout the lungs. We first identified a PAM locus by homozygosity mapping to 4p15, then identified, by a candidate-gene approach, the gene responsible for the disease as SLC34A2 (the type IIb sodium-phosphate cotransporter gene), which is involved in phosphate homeostasis in several organs. We identified six homozygous exonic mutations in the seven unrelated patients with PAM we studied. Three of the mutations were frameshifts, one was a chain termination, one was an amino acid substitution, and one was a deletion spanning the minimal promoter and the first exon. Absence of functional protein product of the gene is compatible with calcium phosphate deposition in alveolar airspaces. We show that impaired activity of the phosphate transporter is presumably responsible for the microliths and that PAM is a recessive monogenic disease with full penetrance. Testicular microlithiasis (TM) is a disease that is more common than PAM. It is often associated with cancer and infertility. Since the gene we identified is also expressed in testis, we searched for mutations in subjects with TM. In 2 of the 15 subjects with TM we studied, we identified two rare variants, one synonymous and the other noncoding, that are possibly associated with the condition.Öğe A new alternative treatment in COPD: phosphodiesterase-4 inhibitors(Turkish Assoc Tuberculosis & Thorax, 2011) Sezgi, Cengizhan; Senyigit, AbdurrahmanChronic obstructive pulmonary disease (COPD) is a disease which is characterized with progressive airflow obstruction and abnormal inflammatory response caused by noxious gases and particles. Recently oral phosphodiesterase-4 (PDE-4) inhibitors which block activation of inflammatory cells, are experimented as a new approach. Last studies showed that these drugs improve symptoms, pulmonary functions and quality of life, reduce the numbers of acute attacks, suppress bronchial inflammation in COPD. However these drugs lead to adverse reactions such as vomiting, diarrhea and headache. In this review we discussed roflumilast (Daxas) which was accepted by Food and Drug Administration (FDA), included in treatment of sever COPD in The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline.Öğe A New Approach in Distinguishing Exudative and Transudative Pleural Effusions(Aves, 2010) Yildiz, Tekin; Senyigit, Abdurrahman; Celik, Yusuf; Akyildiz, Levent; Ates, Gungor; Colakoglu, Sedat; Bayram, HasanObjective: Light's criteria, which were accepted in 1972 for the differential diagnosis of pleural effusions as transudates or exudates, are widely used worldwide. It has been reported in various studies that Light's criteria have lower specificity, and new recommendations have emerged. The discriminative ability of Light's criteria and adapted formulas, which are our new proposal, were studied by Receiver Operating Characteristics (ROCs) analysis and Area Under the Curves (AUCs). Material and Method: These criteria were evaluated in 451 patients in our study. Of these cases, 151 had transudates, while 300 patients presented with exudates. Results: AUCs of Light's criteria (P/Sprot, P/SLDH, PLDH) were measured as 0.931 (95% CI: 0.899-0.963), 0.936(95% CI: 0.9040967) and 0.957(95% CI: 0.934-0.981), respectively, and the differences between the measured values were found to be statistically significant (p<.001). AUCs of our new adapted formulas (F-1, F-2, F-3) were found to be slightly higher than those of Light's criteria, with the values of 0.987(95% CI: 0.9760.998), 0.935(95% CI 0:. 908-0.963) and 0.980(95% CI: 0.9660.993), respectively, and the differences were also significant (p<. 001). Conclusion: In our opinion, further studies are needed with a wider study population to determine the value of the new formulas in differentiating exudative and transudative pleural effusions. Proving our proposal would be useful in clinical practices.Öğe PET/CT positive in a case with eosinophilic granuloma(Turkish Assoc Tuberculosis & Thorax, 2015) Demir, Melike; Meteroglu, Fatih; Kaya, Halide; Taylan, Mahsuk; Yenibertiz, Derya; Yilmaz, Sureyya; Senyigit, Abdurrahman[Abstract Not Available]Öğe Pulmonary Alveolar Microlithiasis: Radiologic Findings of Eight Cases in Turkey(Ortadogu Ad Pres & Publ Co, 2010) Tanrikulu, A. Cetin; Dagli, Canan Eren; Senyigit, Abdurrahman; Nazaroglu, Hasan; Babayigit, CenkObjective: Pulmonary alveolar microlithiasis (PAM) is a rare idiopathic disease characterized by presence of diffuse innumerable minute calculi called microliths The aim of this report was to describe the radiographic findings of PAM with particular attention to features provided by chest X-ray and high resolution computerized tomography (HRCT). Material and Methods: We diagnosed three index cases of PAM who came from the same village in 1996. In 2005 we performed a study including 279 residents of that village by using microfilm screening to determine undiagnosed cases. Five additional cases of PAM were detected and underwent HRCT. HRCT and chest X-ray images of eight cases were assessed specifically for patterns, distribution, and profusion of pulmonary abnormalities. Results: Of eight cases, four were adults and four were children. Diffuse typical microcalcifications were detected in chest X-ray in three cases while reticulonodular pattern was seen in three cases and reticular pattern in two cases. Fine microcalcification, parenchymal band and fisssural prominence were the most common findings on HRCT. Small subpleural cysts were detected in five cases but only case 1 showed black pleural line in chest X-ray. One case had small subpleural bullae and bronchiectatic changes in both lower lobes predominantly in the left lung in HRCT. Conclusion: Relatives of a patient with PAM having reticular or reticulonodular pattern in chest X-ray must be investigated in detail for PAM because it can be the early stage of the disease. HRCT has a major importance for the detection of the rapid progression.Öğe Pulmonary Langerhans' Cell Histiocytosis and Diabetes Insipidus: On the occasion of two cases(Aves, 2012) Sezgi, Cengizhan; Abakay, Abdurrahman; Tanrikulu, Cetin; Sen, Hatice Selimoglu; Senyigit, AbdurrahmanPulmonary Langerhans' cell histiocytosis (PLCH) is an uncommon interstitial lung disease with an unknown etiology in smokers. Disease is usually seen with isolated lung involvement and central nervous system involvement is rare. Two PLCH cases, with central diabetes insipidus (DI) determined at diagnosis in one of the cases and during follow-up in the other, is being presented in this report. The patients' ages were 39 and 24, respectively and they were both male patients with a history of smoking. Widely cystic lesions were viewed at high-resolution computed tomography scans (HRCT) and PLCH was detected at the biopsies obtained by video-assisted thoracoscopic surgery (VATS), in both two cases. Therapy was started with 0.5 mg/kg methyl prednisolone for latter case, because of impairment in pulmonary function tests during follow up. On control, after one month therapy, partial improvement was seen for PLCH and the therapy was continued up to 6 months. At the end of the therapy complete remission was seen and corticotherapy was stopped. Desmopressin was started for both cases at 0.1 mg/day, orally. After one month of treatment clinical improvement was observed during control.Öğe RESEARCH BURDEN OF INTERSTITIAL LUNG DISEASES IN TURKEY - RBILD(Mattioli 1885, 2022) Aycicek, Olcay; Cetinkaya, Erdogan; Ucsular, Fatma Demirci; Bayram, Nazan; Senyigit, Abdurrahman; Aksel, Nimet; Atilla, NurhanIntroduction: The aim of our study is to investigate the etiological distribution of ILD in Turkey by stratifying the epidemiological characteristics of ILD cases, and the direct cost of initial diagnosis of the diag-nosed patients. Material-Method: The study was conducted as a multicenter, prospective, cross-sectional, clinical observation study. Patients over the age of 18 and who accepted to participate to the study were included and evaluated as considered to be ILD. The findings of diagnosis, examination and treatment carried out by the cent-ers in accordance with routine diagnostic procedures were recorded observationally. Results: In total,1070 patients were included in this study. 567 (53%) of the patients were male and 503 (47%) were female. The most frequently diagnosed disease was IPF (30.5%). Dyspnea (75.9%) was the highest incidence among the presenting symptoms. Physical examination found bibasilar inspiratory crackles in 56.2 % and radiological findings included reticular opacities and interlobular septal thickenings in 55.9 % of the cases. It was observed that clinical and radiological findings were used most frequently (74.9%) as a diagnostic tool. While the most common treatment approaches were the use of systemic steroids and antifibrotic drugs with a rate of 30.7% and 85.6%, respectively. The total median cost from the patient's admission to diagnosis was 540 Turkish Lira. Conclusion: We believe that our findings compared with data from other countries will be useful in showing the current situation of ILD in our country to discuss this problem and making plans for a solution.Öğe The role of inflammatory biomarkers in obstructive sleep apnea syndrome(European Respiratory Soc Journals Ltd, 2018) Yilmaz, Sureyya; Sen, Hadice Selimoglu; Taylan, Mahsuk; Demir, Melike; Topcu, Fusun; Senyigit, Abdurrahman; Kirbas, Gokhan[Abstract Not Available]Öğe Silicosis Due to Denim Sandblasting: Four Cases(Ortadogu Ad Pres & Publ Co, 2009) Yilmaz, Suereyya; Bogatekin, Guelhan; Senyigit, Abdulhalim; Buyukbayram, Hueseyin; Senyigit, AbdurrahmanIn recent years, there has been a remarkable rise in silicosis cases due to denim sandblasting in our country. Silicosis, most commonly due to the inhalation of silica particles, might lead to interstitial lung disease and pulmonary disease and pulmonary fibrosis, followed by severe respiratory failure. Since this patient group, involving the young population that work in Small work places without insurance, is unregistered, the precise prevelance of the disease is unknown. In this study, four cases who had developed silicosis as a result of working previously for about 23 years in denim sandblasting were presented. The common symptom of these cases was progressive effort dyspnea. For the prevention of slicosis, which is a progressive and preventable disease, taking preventive measures in unregistered work places is essential.Öğe Unusual Combination of Tracheobronchopathia Osteochondroplastica and AA Amyloidosis(Yonsei Univ Coll Medicine, 2009) Kirbas, Goekhan; Dagli, Canan Eren; Tanrikulu, Abdullah Cetin; Yildiz, Fetin; Buekte, Yasar; Senyigit, Abdurrahman; Kiyan, EsenTracheobronchopathia osteochondroplastica (TO) is a rare disorder of unknown cause characterized by the presence of multiple submucosal osseous and/or cartilaginous nodules that protrude into the lumen of the trachea and large bronchi. A simultaneous diagnosis of TO and amyloidosis is rarely reported. In this report, a case initially suspected to be asthma bronchiole that could not be treated, was radiologically diagnosed as TO, and also secondary amyloidosis is presented. A 53 years, man patient reported a 3 years history of dyspnea. Pulmonary function tests (PFTs) showed an obstructive pattern. Chest X-rays revealed right middle lobe atelectasis. FOB and CT detected nodular lesions in the trachea and in the anterior and lateral walls of the main bronchi. AA amyloidosis was confirmed by endobronchial biopsy. In the abdominal fat pad biopsy, amyloidosis was not detected. Asthma bronchiole was excluded by PFTs. This case illustrates that it is possible for TO and amyloidosis to masquerade as asthma. TO and amyloidosis should be suspected in patients of older ages with asthma and especially with poorly treated asthmatic patients. Although nodular lesions in the anterior and lateral tracheobronchial walls are typical for TO, a biopsy should be obtained to exclude amyloidosis.
