Yazar "Gunen, H" seçeneğine göre listele
Listeleniyor 1 - 13 / 13
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Association between cytokines in induced sputum and severity of chronic obstructive pulmonary disease(W B Saunders Co Ltd, 2006) Hacievliyagil, SS; Gunen, H; Mutlu, LC; Karabulut, AB; Temel, ICytokines are known to be increased in induced sputum in chronic obstructive pulmonary disease (COPD). In this study, the relationship between the levels of interleukin-6 (IL-6), interleukin-8 (IL-8), and tumour necrosis factor-alpha (TNF-alpha) in induced sputum of patients with exacerbation of COPD, and the severity of the disease, pulmonary function tests (PFT), arterial blood gases (ABG) were studied. Twenty-four patients with exacerbation of COPD were included in the study. The patients were grouped according to their PFT into two as: Group 1 (FEV, below 50% of the predicted value, severe-very severe COPD, n = 12) and, Group 2 (FEV, above 50% of the predicted value, mild-moderate COPD, n = 12). The levels of IL-6, IL-8 and TNF-alpha in induced sputum of the subjects were measured. The mean levels of IL-6, IL-8 and TNF-alpha in induced sputum were found to be higher in Group 1 (severe-very severe COPD) than in Group 2 (mild-moderate COPD). The differences in IL-6 and IL-8 levels between groups were statistically significant (P < 0.05). A significant correlation was observed between the IL-6 value and FEV1 (r = -0.435, P = 0.034), FEV1/FVC (r = -0.446, P = 0.029), PaO2 (r = -0.711, P = 0.000), SaO(2) (r = -0.444, P = 0.030) and disease duration (r = 0.427, P = 0.037), respectively. Also, the level of IL-8 in induced sputum was inversely correlated with FEV1 (r = -0.562, P = 0.004), PaO2 (r = -0.540, P = 0.006) and SaO(2) (r = -0.435, P = 0.034). However, all three cytokines were positively correlated with the smoking load (r = 0.653, P = 0.001; r = 0.439, P = 0.032; r = 0.649, P = 0.001). We conclude, therefore, that in exacerbated COPD cases with greater degrees of obstruction of the airways have higher levels of cytokines in induced sputum. This can be interpreted to mean that these cytokines are related to the clinical parameters like the ABG and PFT and seem to be the determinant of the severity of the disease. (c) 2005 Elsevier Ltd. All rights reserved.Öğe Asthma, age, and early reversibility testing(Taylor & Francis Ltd, 2003) Kizkin, O; Turker, G; Hacievliyagil, SS; Gunen, HThe aim of this study was to assess the effect of age on early reversibility testing (ERT) in patients with asthma. Forty-nine nonsmokers with asthma were investigated. In all cases, disease duration was less than 15 years; the absolute change (absolute variability, AV) in forced expiratory volume in I second (FEV1) on ERT was greater than 100 mL; and the increase in FEV1, on ERT was greater than 10%. Patients were categorized as group I (younger than 50 years; n = 24) and group 11 (50 years or older; n = 25). There were no significant differences between the groups regarding disease duration and severity. The mean patient ages in groups I and 11 were 40.3 +/- 7.9 years and 59.2 +/- 7.1 years, respectively, and the corresponding mean baseline FEV1 values were 62.2 +/- 23.7% and 67.4 +/- 21.1% of predicted value (p > 0.05). Pulmonary function tests were performed at baseline, and then repeated for ERT 20 minutes after inhalation of 200 mug salbutamol. After ERT, the respective findings for groups I and 11 were as follows: AV 412 +/- 184mL and 247 +/- 138mL; percentage change (PC) in FEV1 21.5 +/- 9.3% and 16.9 +/- 7.5%; and percent of predicted change (PPC) in FEV1 13.6 +/- 6.5% and 9.9 +/- 4.9%. The AV, PC, and PPC values for group I all were higher than the corresponding findings for group 11, and the differences in AV and PPC were statistically significant (p = 0.001, p < 0.05). The study showed that elderly asthma patients exhibit significantly lower AV and PPC after ERT. To improve the accuracy of asthma diagnosis in elderly patients, limits of ERT should be redefined.Öğe Effect of obesity on P wave duration and P wave dispersion(Nature Publishing Group, 2004) Ari, F; Sabin, I; Kosar, F; Taskapan, H; Gunen, H; Yildiz, R[Abstract Not Available]Öğe Effects of co-existence of coronary stenosis and the extent of coronary ectasia on the TIMI frame count in patients with coronary artery ectasia(Int Heart Journal Assoc, 2005) Kosar, F; Acikgoz, N; Sahin, I; Topal, EU; Gunen, H; Ermis, N; Cehreli, SThe measurement of the thrombosis in myocardial infarction (TIMI) frame count is a simple method for evaluating coronary blood flow. Although it is well known that slow coronary flow is present in patients with coronary artery ectasia (CAE), the effects of coexisting stenosis and the severity of ectatic involvement on coronory flow have not been adequately studied. Thus, we examined (1) the effect of coexistence of obstructive coronary artery disease on TIMI frame count (TFC) and (2) the relation between the severity of ectatic involvement and TFC in patients with CAE. Ninety-seven study patients with CAE were examined in two steps to determine if they were appropriate in terms of the aim of this study. In the first step, ectasias were divided into three groups: an isolated CAE group, a CAE group with coexisting nonsignificant stenosis, and CAE with coexisting significant stenosis. In the second step, ectasias were subdivided into three groups: CAE with one segment, two segments, and three segments (or diffuse) involvement. The TIMI frame counts for the right coronary artery (RCA), the left circumflex coronary artery (LCx), and the left anterior descending artery (LAD) in the ectasia,roup were significantly higher than that of the control group (P < 0.001 P < 0.05, P < 0.05, respectively). The presence of coexisting nonsignificant stenosis or coexisting significant stenosis in patients with CAE did not influence TFC (P > 0.05, For all). In addition, the severity of ectasia involvement, regardless of the localization of ectatic segments and the type of the affected vessel. did not change the TFC (P > 0.05, for all). These results suggest that neither the coexisting stenosis nor the extent of involvement significantly affect TFC in patients with coronary ectasia.Öğe Evaluation of autonomic activity in patients with subclinical hypothyroidism(Springer, 2005) Sahin, I; Turan, N; Kosar, F; Taskapan, C; Gunen, HIt has been shown that impaired cardiac autonomic activity is closely related with lethal arhythmias. Heart rate variability (HRV), analysis of beat-to-beat variations, is an important and widely used non-invasive method to assess autonomic function. Impaired cardiac autonomic activity and altered sympathovagal balance were previously documented in patients with hypothyroidism. However, the effect of subclinical hypothyroidism (SH) on autonomic function has not been studied yet. We aimed to investigate the effect of SH on sympathovagal balance using the HRV method. The study included 31 patients with SH and 28 healthy volunteer controls. Patients with cardiac, metabolic, neurological disease or any other systemic disease that could affect autonomic activity were excluded from the study. HRV time domain and frequency domain parameters were determined over a period 24 h. All time and frequency domain measures of HRV in patients with SH were not significantly different compared to those of healthy control group (p > 0.05). Additionally, we compared SH subgroups (TSH level >= 10 and TSH level < 10 mU/l) with each other and the controls. A statistically significant difference was observed only in time domain parameters of SD of normal-to-normal intervals (SDNN) and SD of all 5-min mean normal NN intervals (SDANN) between subgroup with TSH level >= 10 and controls (p < 0.05, p < 0.05, respectively). In correlation analysis with TSH, there was positive relationship between TSH and the root mean square of successive differences between adjacent R-R intervals (rMSSD). These findings indicate that SH may affect cardiac autonomic activity in correlation with TSH levels. (c) 2005, Editrice Kurtis.Öğe Factors affecting survival of hospitalised patients with COPD(European Respiratory Soc Journals Ltd, 2005) Gunen, H; Hacievliyagil, SS; Kosar, F; Mutlu, LC; Gulbas, G; Pehlivan, E; Sahin, IFactors determining in-hospital mortality and long-term survival of patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are not precisely understood. The aim of the present study was to assess the parameters related to in-hospital mortality and long-term survival after hospitalisation of patients with AECOPD. Clinical and epidemiological parameters on admission in 205 consecutive patients hospitalised with AECOPD were prospectively assessed. Patients were followed-up for 3 yrs. Factors determining short- and long-term mortality were analysed. In total, 17 patients (8.3%) died in hospital. In-hospital mortality was significantly associated with lower arterial oxygen tension (Pa,O-2), higher carbon dioxide arterial tension, lower arterial oxygen saturation and longer hospital stay. The overall 6-month mortality rate was 24%, with 1-, 2- and 3-yr mortality rates of 33%, 39% and 49%, respectively. Cox regression analysis revealed that long-term mortality was associated with longer disease duration (relative risk (RR)=1.158), lower albumin (RR=0.411), lower Pa,O-2 (RR=0.871) and lower body mass index (RR=0.830). When the model was run for the time elapsed since first hospitalisation, it also appeared as statistically significant (RR=1.195). These findings show that patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease have poor short- and long-term survival. Prediction of survival status may be enhanced by considering arterial oxygen tension, albumin, body mass index, disease duration and time elapsed since the first hospitalisation.Öğe Increased plasma viscosity in patients with history of pulmonary embolism(Amer Coll Chest Physicians, 2004) Mutlu, LC; Tek, I; Hacievliyagil, SS; Gunen, H; Kaya, A; Numanoglu, N; Yetkin, O[Abstract Not Available]Öğe Prevalence and clinical significance of a patent foramen ovate in patients with chronic obstructive pulmonary disease(W B Saunders Co Ltd, 2006) Hacievliyagil, SS; Gunen, H; Kosar, FM; Sahin, I; Kilic, TBackground: A patent foramen ovate (PFO) is not widely recognized as a factor contributing to hypoxemia in patients with chronic obstructive pulmonary disease (CCPD). We therefore sought to clarify the prevalence and clinical significance of a PFO in patients with COPD, and to analyze the factors related to its occurrence. Methods: This study included 52 consecutive stable patients with COPD and 50 healthy controls. The demographic and clinical features of the study group were noted. To test for a PFO, standard and contrast transthoracic echocardiographic examinations were performed while resting and during the Valsalva maneuver (VM). Patients performed 6-min walking tests (6 MWT), and the distances traveled were measured. Results: During VM, we detected a PFO in 23 COPD patients and 10 healthy controls (P < 0.01). A PFO was detected while resting in 11 COPD patients, but in none of the controls (P = 0.001). Comparison of multiple parameters between COPD patients with and without a PFO during VM did not reveal any clinically significant differences. When we compared COPD patients with and without a PFO during resting, however, we found that the former had longer durations of disease, lower PaO2 and SaO(2), higher dyspnea scores, shorter distances walked during 6 MWT and higher desaturation rates (P < 0.05). Logistic regression analysis showed that longer duration of disease, lower SaO(2) and higher systolic pulmonary artery pressure were independent predictors of the occurrence of a PFO in resting COPD patients. Conclusions: The prevalence of a PFO is higher in patients with COPD than in healthy individuals. The presence of a PFO while resting may contribute significantly to the deterioration of arterial oxygenation and performance status. These findings indicate that a PFO may be a principle cause of hypoxemia in patients with COPD. (c) 2005 Elsevier Ltd. All rights reserved.Öğe Proteolytic enzyme sensitivity and decrease in respiratory function (a 10-year follow-up)(Springer, 2002) Kizkin, O; Suleyman, GT; Hacievliyagil, S; Gunen, HObjectives: In workers, sensitivity and occupational asthma are known to develop in reaction to the proteolytic enzymes used in the manufacture of detergents. This study was conducted to find out how this sensitivity to the proteolytic enzymes affects respiratory function, excluding occupational asthma. Methods: Workers in the detergent industry (n = 65) were divided into four groups according to their prick-test results, as follows: those positive for at least one enzyme (Lipolase, Savinase) (group I, n = 15); enzyme-negative cases (group II, n = 50); and from among these, enzyme-positive non-smoking cases (group Ia, n = 11); enzyme-negative non-smoking cases (group IIa, n = 32) Respiratory function tests for the last 10 years from the archives were assessed. For statistic analysis, average values were determined and the standard deviation calculated. For comparison of the groups, the Mann-Whitney U and Fischer Exact chi-square tests were used. Results: The ratio of smokers, the cigarette burden, average age and the period of work were found to be similar between workers of groups I and II, and group Ia and group IIa (P>0.05). The average annual fall in the forced vital capacity (FVC) and the forced expiratory volume in the first second (FEV1) for the 10-year period was, respectively, found to be: group I, 64.1 +/- 7.8 ml and 58.7 +/- 9.6 ml; group II, 38.7 +/- 6.4 ml and 43.7 +/- 18.2 ml; group Ia, 60.7 +/- 8.1 ml and 56.1 +/- 10.2 ml; group IIa, 37.4 +/- 6.8 ml and 42.9 +/- 8.1 ml. The decrease in FVC and FEV1 in group I compared with group II, and in group Ia compared with group IIa was statistically significant (P<0.001). Conclusions: In this study, the observation that the FVC and FEV1 of the workers were much lower than expected, especially among those sensitive to the enzymes, independently of occupational asthma and cigarette smoking, led to the conclusion that it could be due to sensitivity to the enzymes.Öğe The role of arterial blood gases, exercise testing, and cardiac examination in asthma(Ocean Side Publications Inc, 2006) Gunen, H; Hacievliyagil, SS; Kosar, F; Gulbas, G; Kizkin, O; Sahin, IThe severity of bronchial asthma may not be assessed easily in some patients using the current evaluation methods. In this study, we aimed to obtain more objective and detailed data in evaluating patients with stable mild and moderate bronchial asthma and to validate the current parameters against more objective ones in determining the disease severity. One-hundred six stable patients with bronchial asthma were included in the study. These patients underwent spirometric and cardiological examination, 6-minute walk testing (6MWT) and arterial blood gas analysis. Continuous measurement of pulse oxymetry (SpO(2)) was done during 6MWT. Dyspnea that developed during 6MWT was measured using the modified Borg category scale. Sixteen patients were found severely hypoxemic at rest, and 16 patients were severely desaturated at 6MWT. Nineteen patients had pulmonary hypertension on echocardiography. Patients with oxygenation problems were older and had longer disease duration, lower forced expiratory flow of 25-75%, higher Borg exercise rating, and higher pulmonary artery pressure (p < 0.05). Patients with pulmonary hypertension had earlier disease onset, lower forced expiratory flow of 25-75%, lower arterial oxygen tension and lower pre-6MWT SpO(2) (P < 0.05), older age, and lower SpO(2) at 6MWT (p < 0.01). Classic evaluation methods correctly operated only on the two-thirds of asthmatic patients. Cardiological examination, 6MWT, and arterial blood gas analysis were needed for the true evaluation of other patients who had potentially progressive disease. We think that evaluation of asthmatic patients with these more objective and detailed methods provides important additional clinical data.Öğe Stages of copd, pulmonary function test, anthropometric measurements and relationship with nutrition(European journal of publıc health, 2018) Mete, B; Pehlivan, E; Gulbas, G; Gunen, HÖğe Thoracic involvement in Behcet's disease and its correlation with multiple parameters(Springer, 2000) Gunen, H; Evereklioglu, C; Kosar, F; Er, H; Kizkin, OIn Behcet's disease (BD), controversy has existed over the incidence of thoracic involvement, which may be a direct threat to the patient's life. The aim of this study is to evaluate the incidence of thoracic involvement in ED and its correlation with the number of diagnostic ED criteria of The International Study Group (ISG), gender, disease duration, and the presence of symptoms. Forty-two ED patients, who had consecutively applied to different clinics in Turgut Ozal Medical Center Research Hospital, were included in the study. They were either newly diagnosed or already under treatment. All patients were examined by standard chest roentgenogram, spirometry, and thorax CT. Perfusion scintigraphies were obtained in patients with thoracic involvement. Thoracic pathologic conditions were found in five patients (11.9%). All thoracic pathologic conditions appeared in patients with at least four diagnostic criteria (26 patients) of the ISG for ED. In this subgroup, the rate of thoracic involvement was 19.2%. Also, 25% of the patients with pulmonary symptoms (12 patients) had thoracic lesions. Gender and the duration of the disease did not correlate with thoracic involvement. Our findings suggest that the rate of thoracic involvement in ED is greater than is generally believed. An increased number of diagnostic ED criteria of the ISG may indicate other organ system involvement and an increased risk of thoracic pathosis. All ED patients with at least four diagnostic criteria or any pulmonary symptoms should be evaluated for thoracic involvement, which is a major menace to life and necessitates early intervention.Öğe Utility of blind forceps biopsy of the main carina and upper-lobe carina in patients with non-small cell lung cancer(Elsevier, 2001) Gunen, H; Kizkin, O; Tahaoglu, C; Aktas, OBackground and objective: Preoperative detection of non-small cell lung cancer (NSCLC) metastasis to the main carina and upper-lobe carina can alter the operative approach, preclude further staging procedures, and save many patients from thoracotomy. This stum assessed whether bronchoscopic forceps biopsy of the normal-appearing main carina and upper-lobe carina (blind biopsy) ipsilateral to the primary NSCLC lesion improved the accuracy of cancer staging and helped guide the management of these patients. Patients and methods: A prospective study of 52 patients was carried out at the SSK Surveyypasa Center for Chest Disease and Cardiothoracic Surgery. Over a 6-month period, we bronchoscopically evaluated 52 consecutive NSCLC patients who were radiologically classified as operable. At least five blind forceps biopsy specimens were obtained from the main carina and/or upper-lobe carina during each patient's initial fiberoptic bronchoscopic examination. Biopsy specimens were collected from the main carina and upper-lobe carina in 51 and 17 patients, respectively. Initially, all patients were staged and evaluated for operability in standard fashion, without histologic assessment of the blind biopsy specimens. We then restaged the disease and reassessed the patients' operability in light of the biopsy findings. Results: Metastasis was histologically diagnosed in seven patients (13.7%) who underwent main carina biopsy and in four patients (23.5%) who underwent upper-lobe carina biopsy. Cancer-positive blind biopsy results changed the status of 25% (6 of 24) of patients from operable to inoperable, and changed the surgical approach in 11.1% (2 of 18) of patients who ultimately did undergo surgery. We found no statistical relationship between metastasis to either carina and tumor type, stage of disease, visibility of the tumor on fiberoptic bronchoscopy, primary tumor location, T status, or N status (p > 0.05). Conclusions: A blind forceps biopsy of the main carina and upper-lobe carina ipsilateral to the lesion site should be done routinely at initial bronchoscopic examination of all radiologically operable patients with suspected lung cancer. This type of screening can save a significant number of NSCLC patients from inappropriate or unnecessary thoracotomy and further staging procedures with their associated morbidity and risk.
