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    Diffusion-weighted MR imaging of pleural fluid
    (Springer, 2004) Baysal, T; Bulut, T; Gökirmak, M; Kalkan, S; Dusak, A; Dogan, M
    The aim of this study was to evaluate the ability of diffusion-weighted MRI in differentiating transudative from exudative pleural effusions. Fifty-seven patients with pleural effusion were studied. Diffusion-weighted imaging (DWI) was performed with an echo-planar imaging (EPI) sequence (b values 0, 1000 s/mm(2)) in 52 patients. The apparent diffusion coefficient (ADC) values were reconstructed from three different regions. Subsequently, thoracentesis was performed and the pleural fluid was analyzed. Laboratory results revealed 20 transudative and 32 exudative effusions. Transudates had a mean ADC value of 3.42+/-0.76x10(-3) mm(2)/s. Exudates had a mean ADC value of 3.18+/-1.82x10(-3) mm(2)/s. The optimum cutoff point for ADC values was 3.38x10(-3) mm(2)/s with a sensitivity of 90.6% and specificity of 85%. A significant negative correlation was seen between ADC values and pleural fluid protein, albumin concentrations and lactate dehydrogenase (LDH) measurements (r=-0.69, -0.66, and -0.46, respectively; p<0.01). The positive predictive value, negative predictive value, and diagnostic accuracy of ADC values were determined to be 90.6, 85, and 88.5%, respectively. The application of diffusion gradients to analyze pleural fluid may be an alternative to the thoracentesis. Non-invasive characterization of a pleural effusion by means of DWI with single-shot EPI technique may obviate the need for thoracentesis with its associated patient morbidity.
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    Effects of Ranitidine on pulmonary function tests of patients with chronic obstructive pulmonary disease
    (Academic Press Ltd- Elsevier Science Ltd, 2003) Hasanoglu, HC; Yidirim, Z; Hasanoglu, A; Ozcan, C; Gokirmak, M; Koksal, N; Kalkan, S
    Since the incidence of peptic ulcer and gastroesophageal reflux (GER) is more common in patients with chronic obstructive pulmonary disease (COPD) than normal population, H-2 receptor blockers are given more extensively to COPD patients. This study evaluated the effects of Ranitidine on pulmonary function tests (PFT) of the patients having COPD and peptic ulcer or GER, and of healthy volunteers. Fifty milligrams of Ranitidine was given intravenously to 30 COPD patients and 25 healthy volunteers. PFT were done before and 15, 30, 60, 120 min after Ranitidine injection. Although mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and forced midexpiratory flow rate (FEF25-75%) Of COPD patients were found to be decreased 60 and 120 min after Ranitidine injection, the decrements were statistically insignificant. The decrements in PFT of healthy volunteers were also not statistically significant. H-2 receptor blockers can be used safely for treatment of gastrointestinal disorders in COPD patients who have mild or moderate obstruction. Minimal decreases in FEV1 and FVC due to treatment by H-2 receptor blockers may clinically worsen COPD patients who have severe obstruction. (C) 2003 Elsevier Science Ltd. All rights reserved.