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Ciloglu D, Karaman A. Corrigendum to <A Numerical Simulation of the Airflow and Aerosol Particle Deposition in a Realistic Airway Model of a Healthy Adult> [Journal of Pharmaceutical Sciences Volume 111 (2022) 3130-3140]. J Pharm Sci 2024:S0022-3549(24)00122-9. [PMID: 38561053 DOI: 10.1016/j.xphs.2024.03.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Dogan Ciloglu
- Vocational College of Technical Sciences, Ataturk University, Erzurum, Turkey.
| | - Adem Karaman
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Turkey
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Karaman A, Abbasguliyev H. Editorial for "Predictive Value of 18 F-FDG PET/MRI for Pleural Invasion in Solid and Subsolid Lung Adenocarcinomas Smaller Than 3 cm". J Magn Reson Imaging 2023; 58:187-188. [PMID: 36222571 DOI: 10.1002/jmri.28442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 06/11/2023] Open
Affiliation(s)
- Adem Karaman
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Hasan Abbasguliyev
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey
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Aydin F, Yalcin A, Karaman A, Sade R, Ozturk G, Alper F, Alper F. Diagnostic and Management Perspectives in Alveolar Echinococcosis: Review of Literature. Eurasian J Med 2022; 54:10-15. [PMID: 36655439 DOI: 10.5152/eurasianjmed.2022.22308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Alveolar echinococcosis is a life-threatening zoonotic disease caused by Echinococcus multilocularis. The disease usually primarily involves the liver and shows tumor-like growth. Early diagnosis of alveolar echinococcosis is difficult because the disease is usually asymptomatic in the early stages. Untreated cases are fatal and result in death within 10 years of liver involvement. In the diagnosis of alveolar echinococcosis, the patient's medical history, radiological imaging findings, and serological and histopathological tests are used together. Radiological imaging methods are very important for early diagnosis and differential diagnosis of the disease. In this article, we wanted to review the diagnosis and treatment of alveolar echinococcosis and emphasize the importance of keeping it in mind, especially in cystic lesions of the liver, and the importance of early diagnosis of the disease.
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Affiliation(s)
- Fahri Aydin
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Ahmet Yalcin
- Atatürk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Adem Karaman
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Recep Sade
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Gurkan Ozturk
- Ataturk University, Faculty of Medicine, Department of General Surgery, Erzurum, Turkey
| | - Fatih Alper
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
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Kızıloğlu HA, Karaman A, Dilek O, Kasali K, Alper F. Evaluation of pulmonary nodules by magnetic resonance imaging sequences: which sequence will replace computed tomography? Rev Assoc Med Bras (1992) 2022; 68:1519-1523. [PMID: 36449768 PMCID: PMC9720765 DOI: 10.1590/1806-9282.20220215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study aimed to determine the role of magnetic resonance imaging in minimizing radiation exposure, especially in the follow-up of pulmonary nodules. METHODS Patients who applied to our hospital between April 2013 and August 2018 for various reasons and had lung-mediastinal dynamic magnetic resonance imaging and thoracic computed tomography were included in the study. A total of 194 patients were included in the study, involving 84 females and 110 males. Scanning of the nodules was done retrospectively. This study was conducted by two readers: a thoracic radiologist with 15 years of experience and a nonspecific radiologist with 4 years of experience. Evaluations were made using the double-blind method. RESULTS Of the 194 patients, 84 (43.3%) were female and 110 (56.7%) were male. For the first reader, 135 (69.5%) nodules were detected in postcontrast T1 vibe images, 130 (67%) in T2 fast spin echo, 128 (66%) in precontrast T1 vibe, and 98 (50.5%) in T2 turbo inversion recovery magnitude sequence. For the second reader, 133 (68%) nodules were detected in postcontrast T1 vibe images, 120 (61.9%) in T2 fast spin echo, 122 (62.9%) in precontrast T1 vibe, and 99 (51%) in T2 turbo inversion recovery magnitude sequence. Capability levels were examined in detecting nodules between the first and second readers, and the ratios were reached at 0.92 in T2 fast spin echo, 0.81 in postcontrast T1 vibe images, 0.93 in precontrast T1 vibe, and 0.96 in T2 turbo inversion recovery magnitude sequence. CONCLUSION In this study of detecting pulmonary nodules by magnetic resonance imaging, which we performed with two different readers, one of whom was an experienced thoracic radiologist, both readers found the highest detection rate in the postcontrast T1 vibe sequence.
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Ciloglu D, Karaman A. A Numerical Simulation of the Airflow and Aerosol Particle Deposition in a Realistic Airway Model of a Healthy Adult. J Pharm Sci 2022; 111:3130-3140. [PMID: 35948158 DOI: 10.1016/j.xphs.2022.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/04/2022] [Accepted: 08/04/2022] [Indexed: 12/14/2022]
Abstract
Determining the behavior of aerosol drug particles is of vital importance in the treatment of respiratory tract diseases. Despite the development of imaging techniques in the pulmonary region in recent years, current imaging techniques are insufficient to detect particle deposition. Computational fluid dynamics (CFD) methods can fill the gap in this field as they take into account the very different physical processes that occur during aerosol transport. This study aims to numerically investigate the airflow and the aerosol particle dynamics on a realistic human respiratory tract model during multiple breathing cycles. The simulations were conducted on the different breathing conditions for people under light, normal, and heavy physical activities, and the aerosol particles with different aerodynamic diameters (i.e., dp=2, 5, and 7 µm). The numerical results were validated by comparing extensively with experimental and numerical results. The results indicated that the airflow during inspiration and expiration was characteristically different from each other and changed with the inspiration flow rate. It was determined that small-sized particles followed the streamlines and moved towards the distal of the lung under low respiratory conditions. On the other hand, larger particles tended to deposit in higher generations due to the higher inertia. It was found that with the increase of inspiration flow rate the deposition of particles increased for all particles during multiple breaths. For light breathing conditions, low deposition efficiencies were obtained because the particles followed the streamlines and moved towards the distal part of the lung. The particle deposition efficiency under heavy breathing conditions was 28.2% for 2 µm, 33.05% for 5 µm, and 38.4% for 7 µm particles. The results showed that inertial impaction plays an active role in particle deposition.
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Affiliation(s)
- Dogan Ciloglu
- Vocational College of Technical Sciences, Ataturk University, Erzurum, Turkey.
| | - Adem Karaman
- Department of Radiology, Faculty of Medicine, Ataturk University, 25240 Erzurum, Turkey
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Karaman A, Sagkal Midilli T. The relationship between nurses' perceptions and competency about spiritual care and influencing factors. Perspect Psychiatr Care 2022; 58:1021-1028. [PMID: 34105169 DOI: 10.1111/ppc.12894] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/01/2021] [Accepted: 05/30/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aims to investigate the relationship between nurses' perceptions and their competences in spiritual care and influencing factors. DESIGN AND METHODS This correlational study was conducted with 700 nurses. The Spirituality and Spiritual Care Rating Scale (SSCRS) was used to determine nurses' spirituality perceptions. The Spiritual Care Competence Scale (SCCS) was used to evaluate the nurses' spiritual care competence. FINDINGS The study results show a significant relationship between the mean item scores of the SSCRS and the SCCS (r = 0.264, p < 0.01). PRACTICE IMPLICATIONS The nurses' perceptions were high, but their competency in spiritual care was at a medium level.
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Affiliation(s)
- Adem Karaman
- Department of Nursing, Health Sciences Institute, Manisa Celal Bayar University, Manisa, Turkey
| | - Tulay Sagkal Midilli
- Department of Fundamentals Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
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Albez FS, Araz Ö, Yılmazel Uçar E, Alper F, Karaman A, Sağlam L, Akgün M. Long-term follow-up of young denim sandblasters in Turkey. Occup Med (Lond) 2022; 72:403-410. [PMID: 35762845 DOI: 10.1093/occmed/kqac043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Denim sandblasting-induced silicosis is a recently identified occupational disease. AIMS In this study, we aimed to evaluate pulmonary and radiological changes in the long-term follow-up of former denim sandblasters. METHODS Ninety former denim sandblasters were followed from 2007 to 2018. Chest X-rays were evaluated according to the International Labour Organization (ILO) classification. Baseline and final data were compared. Silicosis prevalence, radiological progression and pulmonary dysfunction were evaluated. RESULTS All of the sandblasters were men. Their mean age was 34 ± 5 years, mean follow-up time was 9 ± 2 years (mean time since initial exposure: 17 ± 2 years) and mean duration of exposure was 34 ± 25 months. Rates of radiological progression and decline in pulmonary during follow-up were 63% and 39%, respectively. During follow-up, all patients were diagnosed with silicosis. All workers who were ILO category 0 at baseline (n = 26, 29%) progressed to higher categories. The number of patients in Category 2 doubled and the number of patients in Category 3 increased by 2.5-fold. Eleven patients developed new large opacities and the number of patients with category C opacity increased from 4 to 13. Exposure time was an independent determinant of radiological progression (OR: 1.0, P = 0.036) and decline in pulmonary function (OR: 1.3, P = 0.019). CONCLUSION The prevalence of silicosis in denim sandblasters increases steadily even after exposure is discontinued. Radiological progression was observed in a higher proportion of workers than a decline in lung function. Duration of exposure was the major determinant of disease progression in our study.
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Affiliation(s)
- F S Albez
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - Ö Araz
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - E Yılmazel Uçar
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - F Alper
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - L Sağlam
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - M Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
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Karaman A, Ucar EY, Kaya S, Araz Ö. Is it Cyst or Neoplasm? The Role of Thorax Magnetic Resonance Imaging. Arch Bronconeumol 2021; 57:769. [PMID: 35698986 DOI: 10.1016/j.arbr.2020.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/14/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, 25240 Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240 Erzurum, Turkey
| | - Serhat Kaya
- Department of Radiology, Ataturk University School of Medicine, 25240 Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240 Erzurum, Turkey.
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Durur-Subasi I, Kose D, Yayla M, Sirin B, Karaman A, Calik I, Alper F. Does the cardiovascular drug levosimendan prevent iodinated contrast medium nephrotoxicity with glycerol aggravation in rats? Eur Radiol Exp 2021; 5:49. [PMID: 34786647 PMCID: PMC8595362 DOI: 10.1186/s41747-021-00249-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
Background We investigated whether levosimendan prevents contrast medium nephrotoxicity with glycerol aggravation in rats. Methods Forty-eight Wistar albino rats were assigned to eight groups (n = 6 × 8). No medication was administered to group I (controls); glycerol (intramuscular injection of 25% glycerol, 10 mL/kg) group II; intravenous iohexol 10 mL/kg to group III; glycerol and iohexol to group IV; iohexol and intraperitoneal levosimendan 0.25 mg/kg to group V; glycerol, iohexol, and levosimendan 0.25 mg/kg to group VI; iohexol and levosimendan 0.5 mg/kg to group VII; and glycerol, iohexol, and levosimendan 0.5 mg/kg to group VIII. One-day water withdrawal and glycerol injection prompted renal damage; iohexol encouraged nephrotoxicity; levosimendan was administered 30 min after glycerol injection and continued on days 2, 3, and 4. The experiment was completed on day 5. Serum blood urea nitrogen (BUN) and creatinine levels, superoxide dismutase (SOD) activity, glutathione (GSH), malondialdehyde (MDA) levels, tumour necrosis factor-α (TNF-α), nuclear factor kappa ß (NFK-ß), interleukin 6 (IL-6), and histopathological marks were assessed. One-way analysis of variance and Duncan’s multiple comparison tests were used. Results Levosimendan changed serum BUN (p = 0.012) and creatinine (p = 0.018), SOD (p = 0.026), GSH (p = 0.012), and MDA (p = 0.011). Levosimendan significantly downregulated TNF-α (p = 0.022), NFK-ß (p = 0.008), and IL-6 (p = 0.033). Histopathological marks of hyaline and haemorrhagic cast were improved in levosimendan-injected groups. Conclusion Levosimendan showed nephroprotective properties due to its vasodilator, oxidative distress decreasing and inflammatory cytokine preventing belongings.
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Affiliation(s)
- Irmak Durur-Subasi
- Department of Radiology, International Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu, Goztepe Cikisi No:1, Bagcilar, Istanbul, Turkey. .,Department of Radiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.
| | - Duygu Kose
- Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Muhammed Yayla
- Department of Pharmacology, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Busra Sirin
- Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Ilknur Calik
- Department of Pathology, Faculty of Medicine, Fırat University, Elazig, Turkey
| | - Fatih Alper
- Department of Radiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
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Karaman A, Araz Ö, Ay M, Ucar EY. Dissection of the aberrant right subclavian artery: a very rare finding. Br J Hosp Med (Lond) 2021; 82:1. [PMID: 34601939 DOI: 10.12968/hmed.2021.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mutlu Ay
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Elif Y Ucar
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
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Guven S, Durur-Subasi I, Demirci E, Arikok AT, Karaman A, Han U, Hekimoglu B. Mass and non-mass breast MRI patterns: a radiologic approach to sick lobe theory. Acta Radiol 2021; 62:715-721. [PMID: 32693609 DOI: 10.1177/0284185120941825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND According to sick lobe theory, one or more lobes of the breast are more prone to the development of carcinoma. However, the implications of this theory in breast magnetic resonance imaging (MRI) are unknown. PURPOSE To evaluate the MRI appearance of mass type (multifocal and multicentric diseases) and non-mass type (non-mass enhancements) sick lobe patterns, together with the histopathology results. MATERIAL AND METHODS MRI reports of 2015 patients in two tertiary breast imaging centers between June 2012 and June 2018 were retrospectively reviewed for multifocal-multicentric diseases and segmental, linear, and regional enhancements. A total of 113 patients were included. The specimens obtained by thick needle, vacuum, excisional biopsy/lumpectomy or mastectomy after breast MRI scans were pathologically assessed. The pathologic results were categorized as invasive carcinoma, precursor, and benign proliferative lesions according to the 2012 World Health Organization Classification of Tumors. RESULTS The percentage of underlying benign and precursor invasive lesions was significantly different in patients with mass and non-mass MRI patterns. While the pathology results of mass type patterns were premalignant and malignant in all cases, nearly half of the underlying histologies were benign proliferative subtypes in patients with non-mass type patterns. CONCLUSION In this study, the mass and non-mass patterns derived from sick lobe theory were related to different risks of malignancy in the pathological examinations.
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Affiliation(s)
- Selda Guven
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey
| | - Irmak Durur-Subasi
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
- Istanbul Medipol University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Elif Demirci
- Ataturk University, Faculty of Medicine, Department of Pathology, Erzurum, Turkey
| | - Ata Turker Arikok
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Pathology, Ankara, Turkey
| | - Adem Karaman
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Unsal Han
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Pathology, Ankara, Turkey
| | - Baki Hekimoglu
- University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey
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Çankaya BY, Polat G, Tezcan A, Yalçın A, Sade R, Pirimoğlu RB, Karaman A, Kızıloğlu HA, Alper F, Akgün M. Evaluation of lung densitometric and volumetric changes in silicosis patients using three-dimensional software for multidetector CT and the relationship with profusion scores. Clin Radiol 2021; 76:393.e19-393.e24. [PMID: 33509607 DOI: 10.1016/j.crad.2020.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/24/2020] [Indexed: 11/25/2022]
Abstract
AIM To evaluate the density and volume changes in the lungs of silicosis patients and their relationship with the disease severity classification of the International Labor Organization (ILO). MATERIALS AND METHODS The multidetector computed tomography (CT) images of 44 patients diagnosed with silicosis and 32 controls that underwent thoracic CT due to trauma were evaluated. Patients with silicosis were divided into three categories according to the ILO classification. Data related to the total lung volume, total lung mean density, lung opacity score, percentage of lung high opacity, and mean density in the lower and upper lobes were obtained using three-dimensional (3D) software. RESULTS There was no significant difference between the total lung mean densities of the silicosis and control groups (p=0.213); however, a significant difference was observed between the two groups in terms of the total lung volume (p<0.0001). According to the ILO classification, there was a significant difference between the disease severity categories in relation to the percentage of lung high opacity (p=0.000005). A strong correlation was detected between disease severity and high opacity percentage (p<0.0001, r=0.804). According to the ILO classification, there was also a significant difference between disease severity categories in terms of the lung opacity score (p=0.000144), as well as a moderate correlation between disease severity and opacity score (p<0.0001, r=0.580). CONCLUSION Total lung volume is a CT finding that shows variation in exposure to crystalline silica. The percentage of high opacity determined using multidetector CT is an effective parameter in evaluating disease severity.
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Affiliation(s)
- B Y Çankaya
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey.
| | - G Polat
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Tezcan
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Yalçın
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - R Sade
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - R B Pirimoğlu
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - H A Kızıloğlu
- Ömer Halisdemir Training and Research Hospital, Niğde, Turkey
| | - F Alper
- Department of Radiology, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - M Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Atatürk University, 25240, Erzurum, Turkey
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Araz O, Karaman A, Yilmazel Ucar E, Saglam L, Akgun M. Behçet's Disease: Different Systemic Manifestations at Different Ages. Eurasian J Med 2020; 52:304-306. [PMID: 33209086 DOI: 10.5152/eurasianjmed.2019.19107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 07/18/2019] [Indexed: 11/22/2022] Open
Abstract
Behçet's disease, an inflammatory condition, can involve various systems. The disease usually manifests with dermatologic and ocular signs but can also cause serious symptoms due to pulmonary or neurologic involvement. Although the onset may occur at any age, it typically emerges in the second to fourth decades of life. As in the case presented here, Behçet's disease can manifest with the central nervous system involvement early in life and pulmonary involvement in adulthood.
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Affiliation(s)
- Omer Araz
- Department of Pulmonary Disease, Ataturk University School of Medicine, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Disease, Ataturk University School of Medicine, Erzurum, Turkey
| | - Leyla Saglam
- Department of Pulmonary Disease, Ataturk University School of Medicine, Erzurum, Turkey
| | - Metin Akgun
- Department of Pulmonary Disease, Ataturk University School of Medicine, Erzurum, Turkey
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Abstract
Anticoagulant therapy is a treatment that can cause bleeding complications in many anatomical structures. Intracranial, intramuscular and intraabdominal bleeding are internal bleeding that can be secondary to anticoagulated therapy. The prognosis of these hemorrhages can be very good, depending on the anatomical region involved, or they can be fatal. Early recognition of especially intracranial and renal hemorrhages is important for prognosis. For diagnosis, CT and / or MRI should be evaluated according to the region. Internal bleeding should be kept in mind in cases such as sudden hemoglobin decrease or change in consciousness during anticoagulant therapy.
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Affiliation(s)
- Bahar Yılmaz Çankaya
- Department of Radiology, School of Medicine, Atatürk University, 25240, Erzurum, Turkey.
| | - Fatih Alper
- Department of Radiology, School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, School of Medicine, Atatürk University, 25240, Erzurum, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, 25240, Erzurum, Turkey
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Köse D, Köse A, Halıcı Z, Gürbüz MA, Aydın A, Ugan RA, Karaman A, Toktay E. Do peripheral melatonin agonists improve bone fracture healing? The effects of agomelatine and ramelteon on experimental bone fracture. Eur J Pharmacol 2020; 887:173577. [PMID: 32949602 DOI: 10.1016/j.ejphar.2020.173577] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/15/2022]
Abstract
Melatonin improves fracture healing, but the long-term use of melatonin seems impracticable in the treatment of fracture due to side effects caused by hormonal stress on chronological rhythm. Ramelteon (RAMEL) and agomelatine (AGO) are non-selective peripheral melatonin receptor (MT) agonists. This study investigated the effects on bone fracture healing of these MT agonists, which do not affect the central nervous system. The rats were divided into 6 groups, including Group 1 (SHAM): sham operated group; Group 2 (FRACTURE): femoral fracture control; Group 3 (FR + AGO30): femoral fracture + agomelatine 30 mg/kg; Group 4 (FR + AGO60): femoral fracture + agomelatine 60 mg/kg; Group 5 (FR + RAMEL3): femoral fracture + ramelteon 3 mg/kg; and Group 6 (FR + RAMEL6): femoral fracture + ramelteon 6 mg/kg. After 21 days, the rats were subjected to X-ray imaging. Bone healing was evaluated with hematoxylin-eosin (HE) staining. Messenger RNA (mRNA) expressions of bone formation markers, such as bone alkaline phosphatase (ALP), osteocalcin (OC), and osteopontin (OP), were evaluated by real-time polymerase chain reaction (RT-PCR) and with immunohistochemistry (IHC) staining. The radiographic fracture healing scores were statistically significantly higher in the FR + AGO60 group and the FR + RAMEL3 group than in the FRACTURE group. The histopathology and molecular results supported the radiographic results. It was shown that agomelatine and ramelteon increase bone fracture healing, leading to the conclusion that a preference for agomelatine, an antidepressant, and ramelteon, a sleep aid, will increase bone fracture healing in patients with fractures.
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Affiliation(s)
- Duygu Köse
- Faculty of Medicine, Department of Pharmacology, Ataturk University, Erzurum, Turkey.
| | - Ahmet Köse
- Department of Orthopedics and Traumatology, Erzurum Regional Education and Research Hospital, Turkey
| | - Zekai Halıcı
- Clinical Research, Development and Design Application and Research Center, Ataturk University, Erzurum, Turkey
| | - Muhammed Ali Gürbüz
- Faculty of Medicine, Department of Histology and Embryology Department, Ataturk University, Erzurum, Turkey
| | - Ali Aydın
- Faculty of Medicine, Department of Orthopedics and Traumatology, Ataturk University, Erzurum, Turkey
| | - Rüstem Anıl Ugan
- Faculty of Pharmacy, Department of Pharmacology, Ataturk University, Erzurum, Turkey
| | - Adem Karaman
- Faculty of Medicine, Department of Radiology, Ataturk University, Erzurum, Turkey
| | - Erdem Toktay
- Faculty of Medicine, Department of Histology and Embryology Department, Kafkas Univeristy, Kars, Turkey
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Karaman A, Ucar EY, Kaya S, Araz Ö. Is it Cyst or Neoplasm? The Role of Thorax Magnetic Resonance Imaging. Arch Bronconeumol 2020; 57:S0300-2896(20)30185-X. [PMID: 32576399 DOI: 10.1016/j.arbres.2020.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/14/2020] [Accepted: 05/14/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, 25240 Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240 Erzurum, Turkey
| | - Serhat Kaya
- Department of Radiology, Ataturk University School of Medicine, 25240 Erzurum, Turkey
| | - Ömer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240 Erzurum, Turkey.
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Yılmaz Çankaya B, Karaman A, Albez FS, Polat G, Alper F, Akgün M. The association of silicosis severity with pectoralis major muscle and subcutaneous fat volumes and the pulmonary artery/aorta ratio evaluated by CT. Diagn Interv Radiol 2020; 27:37-41. [PMID: 32209510 DOI: 10.5152/dir.2020.19534] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE Silicosis is an incurable occupational disease that sometimes rapidly progresses with fatal outcomes. We aimed to evaluate the association between disease severity and the change in the pectoralis major muscle volume (PMV), subcutaneous fat volume (SFV), and the pulmonary artery/aorta (P/Ao) ratio in patients with silicosis using computed tomography (CT). METHODS The study included 41 male silicosis patients and 41 control group subjects with available chest CT images. Using dedicated software, we measured PMV and SFV from the axial CT images. We calculated the P/Ao ratio and obtained body mass index (BMI) and forced expiratory volume/forced vital capacity (FEV1/FVC) results from hospital records. We used the chest X-ray profusion score according to the International Labor Organization (ILO) classification to evaluate the severity of the silicosis. RESULTS The mean age was 33.5±4.4 and 34.7±4.7 years in the silicotic and control groups, respectively. The mean BMI, PMV, SFV, and P/Ao values significantly differed between the study and control groups (P = 0.0009, P < 0.0001, P < 0.0001, and P = 0.0029, respectively). According to the ILO classification, there were 12 silicosis patients in category 1, 13 in category 2, and 16 in category 3. A significant difference was found between disease categories in terms of PMV, SFV, P/Ao, BMI, and FEV1/FVC values (P = 0.0425, P = 0.0341, P = 0.0002, P = 0.0492, and P = 0.0004, respectively). CONCLUSION Disease severity had a stronger association with decreased PMV and SFV and increased P/Ao ratios than BMI in patients with silicosis caused by denim sandblasting. Thus, CT evaluation might be a useful indicator of disease severity.
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Affiliation(s)
| | - Adem Karaman
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Fadime Sultan Albez
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
| | - Gökhan Polat
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Fatih Alper
- Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey
| | - Metin Akgün
- Department of Pulmonary Diseases, Atatürk University School of Medicine, Erzurum, Turkey
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18
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Karaman A. What Else Can We Use in The Discrimination of Activated MS Plaques in Addition to Diffusion MRI? Eurasian J Med 2020; 52:98-99. [PMID: 32158324 DOI: 10.5152/eurasianjmed.2020.19238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Acute respiratory distress syndrome is characterized by dyspnea at presentation, tachypnea on physical examination, findings of bilateral infiltration in chest radiography, refractory hypoxia, and high mortality. Although the main treatment approach is to address the underlying disease, there are also pharmacological and nonpharmacological options for supportive treatment. There is currently no pharmacological agent with proven efficacy in this syndrome, and many drugs are being studied for this purpose. One of these is the endothelin receptor antagonist bosentan.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
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Abstract
Lung pathologies in the pediatric population can usually be detected using chest radiography. Multidetector computed tomography (MDCT) imaging is often used as a supplementary method in the evaluation of lung diseases. Recently, magnetic resonance imaging (MRI) techniques were found to be reliable in the evaluation of pulmonary diseases in the pediatric population. This review study describes the routine application of MRI examinations and the use of thoracic MRI with a particular focus in pediatric patients.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
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20
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Yayla M, Cadirci E, Halici Z, Bakan F, Ay N, Demirci S, Karaman A, Sahin F. Regenerative Effect of Resorbable Scaffold Embedded Boron-Nitride/Hydroxyapatite Nanoparticles in Rat Parietal Bone. J Nanosci Nanotechnol 2020; 20:680-691. [PMID: 31383063 DOI: 10.1166/jnn.2020.17128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BN has important roles in several physiological events, including bone growth and immune system. New infection-free cranioplasty and has an osteogenic activities material that are compatible with tissue are being developed. We aimed in our study to examine whether different combinations of Boron-nitride/Hydroxyapatite are embedded into the scaffold in the treatment of calvarial defects. 200 adult female Sprague-Dawley rats divided into 10 equal groups. Osteotomy was made by trepan drill in 8 mm diameter. The scaffolds were placed in the rats and were left to recovery for 2 months. During the experiment, CT scans were taken from the calvarial areas of the rats in the 2nd, 4th and 8th weeks. Significant healing was observed in defect diameters in 2.5% BN+10% HA, 2.5% BN and 5% BN+10% HA, respectively. After 8 weeks, it was seen that the amounts of OPN, BMP-2, RunX2 and ALP mRNA expression significantly decreased in 2.5% BN+10% HA, 2.5% BN, 5% BN+10% HA and 5% BN groups. It was shown that bone recovery was at the best grade in the groups, which contained 2.5% BN and 2.5% BN+10% HA when compared to the other groups. BN is a very promising agent that will be used in reconstructive surgery for the treatment of calvarial bone defects.
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Affiliation(s)
- Muhammed Yayla
- Department of Pharmacology, Kafkas University Faculty of Medicine 36210 Kars, Turkey
| | - Elif Cadirci
- Department of Pharmacology, Faculty of Medicine, Ataturk University 25240 Erzurum-Turkey
| | - Zekai Halici
- Department of Pharmacology, Faculty of Medicine, Ataturk University 25240 Erzurum-Turkey
| | - Feray Bakan
- Nanotechnology Research and Application Center, Sabanci University, Istanbul, 34100, Turkey
| | - Nuran Ay
- Department of Material Engineering, Faculty of Engineering, Anadolu University, 26150 Eskisehir, Turkey
| | - Selami Demirci
- Department of Moleculary Science and Biotechnology, Faculty of Science, Yeditepe University, 34100 Istanbul, Turkey
| | - Adem Karaman
- Department of Radiology, Faculty of Medicine, Ataturk University 25240 Erzurum-Turkey
| | - Fikrettin Sahin
- Department of Moleculary Science and Biotechnology, Faculty of Science, Yeditepe University, 34100 Istanbul, Turkey
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21
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Subasi M, Durur-Karakaya A, Balta H, Karaman A. Compressive Sonoelastography Findings of Esophageal Carcinoma. Eurasian J Med 2019; 51:267-269. [PMID: 31692690 DOI: 10.5152/eurasianjmed.2019.18406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to evaluate the compressive sonoelastography findings of primary esophageal carcinoma. Materials and Methods Esophageal specimens of the patients with a tumor staged earlier than T2, with no lymphadenopathy or distant metastasis, who underwent surgery, were evaluated by compressive sonoelastography under ex vivo conditions immediately following surgical excision. The compressive sonoelastography findings of primary esophageal carcinoma were recorded. Compressive sonoelastography measurements were made according to the esophageal muscle because of lack of fat tissue. Results The mean elasticity score was 3±1 (range, 1-4), and the mean strain ratio was 1±0.9 (range, 0.3-2.9). Conclusion Primary esophageal carcinoma is stiff based on the elasticity score, and it demonstrated a mean strain ratio similar to the esophageal muscle.
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Affiliation(s)
- Mahmut Subasi
- Department of Thoracic Surgery, Erzurum Training and Research Hospital, Erzurum, Turkey; Department of Thoracic Surgery and Lung Transplantation, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Afak Durur-Karakaya
- Department of Radiology, Erzurum Training and Research Hospital, Erzurum, Turkey; Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Hilal Balta
- Department of Pathology, Erzurum Training and Research Hospital, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
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22
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Kerget B, Araz O, Yilmazel Ucar E, Karaman A, Calik M, Alper F, Akgun M. Female workers' silicosis diagnosis delayed due to gender bias. Occup Med (Lond) 2019; 69:219-222. [PMID: 30869783 DOI: 10.1093/occmed/kqz019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
After excluding alternative explanations, a silicosis diagnosis is based on the combination of appropriate silica exposure history and compatible clinical, radiological and occasionally pathological findings. Not taking appropriate occupational history by a physician may cause a misdiagnosis or underdiagnosis of silicosis. Herein, we present a female worker in a small-scale sandblasting factory who worked as a controller. Her silicosis diagnosis was established 10 years after her first symptoms, and she underwent invasive procedures due to a lack of inquiry about her occupational history. Gender bias may be one of the reasons that her occupational history was not taken.
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Affiliation(s)
- B Kerget
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey.,Health Science University, Erzurum, Turkey
| | - O Araz
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey
| | - E Yilmazel Ucar
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey
| | - A Karaman
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - M Calik
- Department of Pathology, School of Medicine, Firat University, Elazig, Turkey
| | - F Alper
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - M Akgun
- Department of Pulmonary Diseases, School of Medicine, Atatürk University, Erzurum, Turkey
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23
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Durur-Subasi I, Durur-Karakaya A, Karaman A, Seker M, Demirci E, Alper F. Is the necrosis/wall ADC ratio useful for the differentiation of benign and malignant breast lesions? Br J Radiol 2017; 90:20160803. [PMID: 28339285 DOI: 10.1259/bjr.20160803] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To determine whether the necrosis/wall apparent diffusion coefficient (ADC) ratio is useful for the malignant-benign differentiation of necrotic breast lesions. METHODS Breast MRI was performed using a 3-T system. In this retrospective study, calculation of the necrosis/wall ADC ratio was based on ADC values measured from the necrosis and from the wall of malignant and benign breast lesions by diffusion-weighted imaging (DWI). By synchronizing post-contrast T1 weighted images, the separate parts of wall and necrosis were maintained. All the diagnoses were pathologically confirmed. Statistical analyses were conducted using an independent sample t-test and receiver operating characteristic analysis. The intraclass and interclass correlations were evaluated. RESULTS A total of 66 female patients were enrolled, 38 of whom had necrotic breast carcinomas and 28 of whom had breast abscesses. The ADC values were obtained from both the wall and necrosis. The mean necrosis/wall ADC ratio (± standard deviation) was 1.61 ± 0.51 in carcinomas, and it was 0.65 ± 0.33 in abscesses. The area under the curve values for necrosis ADC, wall ADC and the necrosis/wall ADC ratio were 0.680, 0.068 and 0.942, respectively. A wall/necrosis ADC ratio cut-off value of 1.18 demonstrated a sensitivity of 97%, specificity of 93%, a positive-predictive value of 95%, a negative-predictive value of 96% and an accuracy of 95% in determining the malignant nature of necrotic breast lesions. There was a good intra- and interclass reliability for the ADC values of both necrosis and wall. CONCLUSION The necrosis/wall ADC ratio appears to be a reliable and promising tool for discriminating breast carcinomas from abscesses using DWI. Advances in knowledge: ADC values of the necrosis obtained by DWI are valuable for malignant-benign differentiation in necrotic breast lesions. The necrosis/wall ADC ratio appears to be a reliable and promising tool in the breast imaging field.
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Affiliation(s)
- Irmak Durur-Subasi
- 1 Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Afak Durur-Karakaya
- 2 Department of Radiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Adem Karaman
- 3 Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Mehmet Seker
- 2 Department of Radiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Elif Demirci
- 4 Department of Pathology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Fatih Alper
- 3 Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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24
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Karaman A, Durur-Subasi I, Alper F, Durur-Karakaya A, Subasi M, Akgun M. Is it better to include necrosis in apparent diffusion coefficient (ADC) measurements? The necrosis/wall ADC ratio to differentiate malignant and benign necrotic lung lesions: Preliminary results. J Magn Reson Imaging 2017; 46:1001-1006. [PMID: 28152254 DOI: 10.1002/jmri.25649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To determine whether the use of necrosis/wall apparent diffusion coefficient (ADC) ratios in the differentiation of necrotic lung lesions is more reliable than measuring the wall alone. MATERIALS AND METHODS In this retrospective study, a total of 76 patients (54 males and 22 females, 71% vs. 29%, with a mean age of 53 ± 18 years, range, 18-84) were enrolled, 33 of whom had lung carcinoma and 43 had a benign necrotic lung lesion. A 3T scanner was used. The calculation of the necrosis/wall ADC ratio was based on ADC values measured from necrosis and the wall of the lesions by diffusion-weighted imaging (DWI). Statistical analyses were performed with the independent samples t-test and receiver operating characteristic analysis. Intraobserver and interobserver reliability were calculated for ADC values of wall and necrosis. RESULTS The mean necrosis/wall ADC ratio was 1.67 ± 0.23 for malignant lesions and 0.75 ± 0.19 for benign lung lesions (P < 0.001). To estimate malignancy the area under the curve (AUC) values for necrosis ADC, wall ADC, and the necrosis/wall ADC ratio were 0.720, 0.073, and 0.997, respectively. A wall/necrosis ADC ratio cutoff value of 1.12 demonstrated a 100% sensitivity and 98% specificity in the estimation of malignancy. Positive predictive value was 100%, and negative predictive value 98% and diagnostic accuracy 99%. There was a good intraobserver and interobserver reliability for wall and necrosis. CONCLUSION The necrosis/wall ADC ratio appears to be a reliable and promising tool for discriminating lung carcinoma from benign necrotic lung lesions than measuring the wall alone. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1001-1006.
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Affiliation(s)
- Adem Karaman
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Irmak Durur-Subasi
- Diskapi Yildirim Beyazit Training and Research Hospital, Clinic of Radiology, Ankara, Turkey
| | - Fatih Alper
- Ataturk University, Faculty of Medicine, Department of Radiology, Erzurum, Turkey
| | - Afak Durur-Karakaya
- Istanbul Medipol University, Faculty of Medicine, Department of Radiology, Istanbul, Turkey
| | - Mahmut Subasi
- Turkiye Yuksek Ihtısas Training and Research Hospital, Clinic of Thoracic Surgery and Lung Transplantation, Ankara, Turkey
| | - Metin Akgun
- Ataturk University, Faculty of Medicine, Department of Chest Diseases, Erzurum, Turkey
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Karaman A, Omeroglu M, Emet M, Kerget B, Subasi ID, Alper F. Lenalidomide Induced Late-Onset Acute Respiratory Distress Syndrome. Eurasian J Med 2016; 48:228-229. [PMID: 28149152 DOI: 10.5152/eurasianjmed.2015.0150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Accepted: 10/16/2015] [Indexed: 12/20/2022] Open
Abstract
A 77-year-old man with multiple myeloma (MM) presented with shortness of breath to the emergency department. He also had history of chronic obstructive pulmonary disease, chronic pulmonary embolism and nephrectomy due to malignancy 10 years ago. He had been treated for 9 months with lenalidomide because of MM. He diagnosed with adult respiratory distress syndrome due to lenalidomide. We aimed to demonstrate late onset and destructive effects of lenalidomide on the lungs.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mevlana Omeroglu
- Department of Emergency Medicine, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mucahit Emet
- Department of Emergency Medicine, Ataturk University School of Medicine, Erzurum, Turkey
| | - Bugra Kerget
- Department of Pulmonology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Irmak Durur Subasi
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Fatih Alper
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
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Karaman A, Diyarbakir B, Durur-Subasi I, Kose D, Özbek-Bilgin A, Topcu A, Gundogdu C, Durur-Karakaya A, Bayraktutan Z, Alper F. A novel approach to contrast-induced nephrotoxicity: the melatonergic agent agomelatine. Br J Radiol 2016; 89:20150716. [PMID: 26886874 DOI: 10.1259/bjr.20150716] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To study the potential nephroprotective role of agomelatine in rat renal tissue in cases of contrast-induced nephrotoxicity (CIN). The drug's action on the antioxidant system and proinflammatory cytokines, superoxide dismutase (SOD) activity, levels of glutathione (GSH) and malondialdehyde (MDA) and the gene expression of interleukin-6 (IL-6), tumour necrosis factor (TNF)-α and nuclear factor kappa B (NF-κB) was measured. Tubular necrosis and hyaline and haemorrhagic casts were also histopathologically evaluated. METHODS The institutional ethics and local animal care committees approved the study. Eight groups of six rats were put on the following drug regimens: Group 1: healthy controls, Group 2: GLY (glycerol), Group 3: CM (contrast media--iohexol 10 ml kg(-1)), Group 4: GLY+CM, Group 5: CM+AGO20 (agomelatine 20 mg kg(-1)), Group 6: GLY+CM+AGO20, Group 7: CM+AGO40 (agomelatine 40 mg kg(-1)) and Group 8: GLY+CM+AGO40. The groups were evaluated by one-way analysis of variance and Duncan's multiple comparison test. RESULTS Agomelatine administration significantly improved the serum levels of blood urea nitrogen (BUN) and creatinine, SOD activity, GSH and MDA. The use of agomelatine had substantial downregulatory consequences on TNF-α, NF-κB and IL-6 messenger RNA levels. Mild-to-severe hyaline and haemorrhagic casts and tubular necrosis were observed in all groups, except in the healthy group. The histopathological scores were better in the agomelatine treatment groups. CONCLUSION Agomelatine has nephroprotective effects against CIN in rats. This effect can be attributed to its properties of reducing oxidative stress and inhibiting the secretion of proinflammatory cytokines (NF-κB, TNF-α and IL-6). ADVANCES IN KNOWLEDGE CIN is one of the most important adverse effects of radiological procedures. Renal failure, diabetes, malignancy, old age and non-steroidal anti-inflammatory drug use pose the risk of CIN in patients. Several clinical studies have investigated ways to avoid CIN. Theophylline/aminophylline, statins, ascorbic acid and iloprost have been suggested for this purpose. Agomelatine is one of the melatonin ligands and is used for affective disorders and has antioxidant features. In this study, we hypothesized that agomelatine could have nephroprotective, antioxidant and anti-inflammatory effects against CIN in rats.
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Affiliation(s)
- Adem Karaman
- 1 Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Busra Diyarbakir
- 2 Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Irmak Durur-Subasi
- 3 Department of Radiology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Duygu Kose
- 2 Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Asli Özbek-Bilgin
- 2 Department of Pharmacology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Atilla Topcu
- 4 Department of Pharmacology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Cemal Gundogdu
- 5 Department of Pathology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | | | - Zafer Bayraktutan
- 7 Department of Biochemistry, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Fatih Alper
- 1 Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Karaman A, Araz O, Durur-Subasi I, Alper F, Subasi M, Karakaya AD, Akgun M. Added value of DCE-MRI in the management of cystic-cavitary lung lesions. Respirology 2015; 21:739-45. [PMID: 26694088 DOI: 10.1111/resp.12717] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/09/2015] [Accepted: 10/11/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE We evaluated the added value of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) to CT in the evaluation of cystic-cavitary lung lesions. We aimed to compare morphological parameters, including wall thickness and inner wall irregularity, and to determine whether DCE-MRI with morphological and dynamic parameters was useful in indeterminate lesions. We also aimed to investigate the added value of DCE-MRI in terms of whether to biopsy, and if so the site of biopsy. METHODS This prospective study included 39 consecutive patients with cystic and/or cavitary lung lesions detected by CT who then underwent additional DCE-MRI. After initial evaluation, the lesions were classified as benign, indeterminate or malignant and the findings of CT and DCE-MRI compared with each other by considering the final diagnosis that was determined by histopathological findings and clinical evaluation and follow up. RESULTS The mean values for wall thickness obtained by DCE-MRI were lower and the range of wall thickness for indeterminate lesions was narrower than those obtained by CT (5.50-11.50 mm and 5.75-13.50 mm for DCE-MRI and CT), and inner wall irregularity on DCE-MRI was more sensitive in malignant lesions. Also, DCE-MRI obviated biopsy in three benign patients and changed the biopsy site in two patients. CONCLUSION Our study suggests that DCE-MRI is helpful in indeterminate cystic-cavitary lung lesions, with morphological and dynamic features. It narrowed the range of wall thickness used for indeterminate lesions, was more sensitive than CT in determining malignant inner wall irregularity, and was also useful in determining the need for and appropriate site of biopsy. See article, page 576.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Omer Araz
- Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Irmak Durur-Subasi
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Fatih Alper
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
| | - Mahmut Subasi
- Department of Chest Surgery, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey
| | - Afak D Karakaya
- Department of Radiology, Istanbul Medipol University, Istanbul, Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases, Faculty of Medicine, Ataturk University, Erzurum, Turkey
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Akgun M, Araz O, Ucar EY, Karaman A, Alper F, Gorguner M, Kreiss K. Silicosis Appears Inevitable Among Former Denim Sandblasters: A 4-Year Follow-up Study. Chest 2015; 148:647-654. [PMID: 25654743 DOI: 10.1378/chest.14-2848] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The course of denim sandblasting silicosis is unknown. We aimed to reevaluate former sandblasters studied in 2007 for incident silicosis, radiographic progression, pulmonary function loss, and mortality and to examine any associations between these outcomes and previously demonstrated risk factors for silicosis. METHODS We defined silicosis on chest radiograph as category 1/0 small opacity profusion using the International Labor Organization classification. We defined radiographic progression as a profusion increase of two or more subcategories, development of a new large opacity, or an increase in large opacity category. We defined pulmonary function loss as a ≥ 12% decrease in FVC. RESULTS Among the 145 former sandblasters studied in 2007, 83 were reassessed in 2011. In the 4-year follow-up period, nine (6.2%) had died at a mean age of 24 years. Of the 74 living sandblasters available for reexamination, the prevalence of silicosis increased from 55.4% to 95.9%. Radiographic progression, observed in 82%, was associated with younger age, never smoking, foreman work, and sleeping at the workplace. Pulmonary function loss, seen in 66%, was positively associated with never smoking and higher initial FVC % predicted. Death was associated with never smoking, foreman work, number of different denim-sandblasting places of work, sleeping at the workplace, and lower pulmonary function, of which only the number of different places worked remained in multivariate analyses. CONCLUSIONS This 4-year follow-up suggests that almost all former denim sandblasters may develop silicosis, despite short exposures and latency.
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Affiliation(s)
- Metin Akgun
- Department of Pulmonary Medicine, Atatürk University, Faculty of Medicine, Erzurum, Turkey.
| | - Omer Araz
- Department of Pulmonary Medicine, Atatürk University, Faculty of Medicine, Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Medicine, Atatürk University, Faculty of Medicine, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, Atatürk University, Faculty of Medicine, Erzurum, Turkey
| | - Fatih Alper
- Department of Radiology, Atatürk University, Faculty of Medicine, Erzurum, Turkey
| | - Metin Gorguner
- Department of Pulmonary Medicine, Atatürk University, Faculty of Medicine, Erzurum, Turkey
| | - Kathleen Kreiss
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV
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Kunak CS, Ugan RA, Cadirci E, Karakus E, Polat B, Un H, Halici Z, Saritemur M, Atmaca HT, Karaman A. Nephroprotective potential of carnitine against glycerol and contrast-induced kidney injury in rats through modulation of oxidative stress, proinflammatory cytokines, and apoptosis. Br J Radiol 2015; 89:20140724. [PMID: 26562095 DOI: 10.1259/bjr.20140724] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Contrast media (CM) are a major cause of nephropathy in high-risk patients. The aim of this study was to examine the effects of carnitine (CAR) in advanced nephrotoxicity due to CM administration in rats with glycerol-induced renal functional disorder. METHODS 40 rats were divided randomly into five groups (n = 8): (1) healthy group; (2) glycerol only (GLY); (3) glycerol and CM (GLY + CM); (4) glycerol, CM and 200 mg kg(-1) carnitine (CAR200, Carnitene(®); Sigma-tau/Santa Farma, Istanbul, Turkey); and (5) glycerol, CM and 400 mg kg(-1) carnitine (CAR400). Kidney injury was induced with a single-dose, intramuscular injection of 10 ml kg(-1) body weight (b.w.) of GLY. CAR was administered intraperitoneally. CM (8 ml kg(-1) b.w. iohexol, Omnipaque™; Opakim Medical Products, Istanbul, Turkey) was infused via the tail vein to the rats in Groups 3-5. RESULTS l-carnitine administration significantly decreased serum creatinine and blood urea nitrogen levels. Superoxide dismutase and glutathione activity increased significantly in the treatment groups compared with the nephrotoxic groups. CAR400 significantly reduced malondialdehyde levels to healthy levels. In the treatment groups, tumour necrosis factor (TNF)-α, transforming growth factor 1β, interleukin 1β and caspase-3 gene expression decreased compared with the nephrotoxic groups. TNF-α and nuclear factor kappa-beta (NF-κB) protein expression increased after CM and CAR administration reduced both TNF-α and NF-κB expressions. Histopathologically, hyaline and haemorrhagic casts and necrosis in proximal tubules increased in the nephrotoxicity groups and decreased in the CAR groups. CONCLUSION The results reveal that l-carnitine protects the oxidant/antioxidant balance and decreases proinflammatory cytokines and apoptosis in CM-induced nephrotoxicity in rats with underlying pathology. ADVANCES IN KNOWLEDGE Depending on the underlying kidney pathologies, the incidence of CM-induced nephropathy (CIN) increases. Therefore, this is the best model to represent clinically observed CIN.
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Affiliation(s)
- Celalettin S Kunak
- 1 Department of Pharmacology, Ordu University Faculty of Medicine, Ordu, Turkey
| | - Rustem A Ugan
- 2 Department of Pharmacology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Elif Cadirci
- 2 Department of Pharmacology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Emre Karakus
- 3 Department of Pharmacology and Toxicology, Ataturk University Faculty of Veterinary Medicine, Erzurum, Turkey
| | - Beyzagul Polat
- 4 Department of Pharmacology, Ataturk University Faculty of Pharmacy, Erzurum, Turkey
| | - Harun Un
- 5 Department of Biochemistry, Agri Ibrahim Cecen University Faculty of Pharmacy, Agri, Turkey
| | - Zekai Halici
- 2 Department of Pharmacology, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Murat Saritemur
- 6 Department of Emergency Medicine, Ataturk University Faculty of Medicine, Erzurum, Turkey
| | - Hasan T Atmaca
- 7 Department of Pathology, Kırıkkale University Faculty of Veterinary Medicine, Kırıkkale, Turkey
| | - Adem Karaman
- 8 Department of Radiology, Ataturk University Faculty of Medicine, Erzurum, Turkey
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Karaman A, Omeroglu M, Emet M, Kerget B, Durur Subasi I, Alper F. Lenalidomide Induced Late-Onset Acute Respiratory Distress Syndrome. Eurasian J Med 2015. [DOI: 10.5152/eurasianjmed.2015.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Emet M, Kocak AO, Akbas I, Karaman A, Arslan S. Spontaneous reduction of ileoileal adult intussusception after blunt abdominal injury. Am J Emerg Med 2015; 33:1542.e3-5. [PMID: 26299690 DOI: 10.1016/j.ajem.2015.07.053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 07/23/2015] [Indexed: 11/28/2022] Open
Abstract
This is the first case report of an adult who had spontaneous reduction of ileoileal intussusception occurred after punching to the abdomen. A 40-year-old man was brought to our emergency department by ground ambulance due to pounding and punching a few hours ago. Physical examination showed multiple dermabrasions on his face, abdomen, and lower extremities. All other examinations were unremarkable except that of mild abdominal pain. Laboratory results gave no clues. On abdominal x-ray, paucity of intestinal gas, pseudomass and surrounding gas appearances were visible. No nausea or vomiting occurred during observation. His abdominal pain resolved gradually. On the 24th hour after admission, control computed tomography showed that the findings of intussusception disappeared. He was discharged after 1 day of observation. Outpatient follow-up did not show any abnormality. We suggest that, in patients with mild to moderate trauma, even if the patient has mild abdominal pain, physicians should rule out invagination. Computed tomography is the suggested imaging modality. These patients should be kept in close follow-up. If symptoms resolve and intussusception findings disappear in computed tomography, no further treatment is required.
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Affiliation(s)
- Mucahit Emet
- Department of Emergency Medicine, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
| | - Abdullah Osman Kocak
- Department of Emergency Medicine, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
| | - Ilker Akbas
- Department of Emergency Medicine, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
| | - Adem Karaman
- Department of Radiology, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
| | - Sukru Arslan
- Department of General Surgery, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
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Karaman A, Durur-Subasi I, Alper F, Araz O, Subasi M, Demirci E, Albayrak M, Polat G, Akgun M, Karabulut N. Correlation of diffusion MRI with the Ki-67 index in non-small cell lung cancer. Radiol Oncol 2015; 49:250-5. [PMID: 26401130 PMCID: PMC4577221 DOI: 10.1515/raon-2015-0032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 07/09/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The primary objective of the study was to evaluate the association between the minimum apparent diffusion coefficient (ADCmin) and Ki-67, an index for cellular proliferation, in non-small cell lung cancers. Also, we aimed to assess whether ADCmin values differ between tumour subtypes and tissue sampling method. METHODS The patients who had diffusion weighted magnetic resonance imaging (DW-MRI) were enrolled retrospectively. The correlation between ADCmin and the Ki-67 index was evaluated. RESULTS Ninety three patients, with a mean age 65 ± 11 years, with histopathologically proven adenocarcinoma and squamous cell carcinoma of the lungs and had technically successful DW-MRI were included in the study. The numbers of tumour subtypes were 47 for adenocarcinoma and 46 for squamous cell carcinoma. There was a good negative correlation between ADCmin values and the Ki-67 proliferation index (r = -0.837, p < 0.001). The mean ADCmin value was higher and the mean Ki-67 index was lower in adenocarcinomas compared to squamous cell carcinoma (p < 0.0001). There was no statistical difference between tissue sampling methods. CONCLUSIONS Because ADCmin shows a good but negative correlation with Ki-67 index, it provides an opportunity to evaluate tumours and their aggressiveness and may be helpful in the differentiation of subtypes non-invasively.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Irmak Durur-Subasi
- Department of Radiology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Fatih Alper
- Department of Radiology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Omer Araz
- Department of Pulmonary Diseases, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Mahmut Subasi
- Department of Thoracic Surgery, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Elif Demirci
- Department of Pathology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Mevlut Albayrak
- Department of Pathology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Gökhan Polat
- Department of Radiology, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases, Ataturk University, Medical Faculty, Erzurum, Turkey
| | - Nevzat Karabulut
- Department of Radiology, Pamukkale University, Medical Faculty, Denizli, Turkey
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Saritemur M, Un H, Cadirci E, Karakus E, Akpinar E, Halici Z, Ugan RA, Karaman A, Atmaca HT. Tnf-α inhibition by infliximab as a new target for the prevention of glycerol-contrast-induced nephropathy. Environ Toxicol Pharmacol 2015; 39:577-588. [PMID: 25682004 DOI: 10.1016/j.etap.2015.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 12/31/2014] [Accepted: 01/10/2015] [Indexed: 06/04/2023]
Abstract
Contrast medium-induced nephropathy (CIN) remains as a problem with high incidence and mortality rates. The aim of this study is to examine the roles of infliximab (INF) in the glycerol (GLY) and CIN model in rats. The rats were separated into five groups (n=8): Healthy, GLY, GLY+CM, GLY+CM+INF 5mg/kg intraperitoneally (i.p.), and GLY+CM+INF 7 mg/kg (i.p.). Antioxidant levels in the therapy groups were observed to be quite similar to those in the healthy group. In this study, while the kidney TNF-α, IL-1β, TGF-1β and Caspase 3 gene expressions' levels increased in the nephrotoxic groups, these levels were found to have decreased in the treatment groups. Moreover, histopathologic examination showed that hyaline, haemorrhagic casts and necrosis were increased in nephrotoxicity group, whereas they decreased in the therapy group. Furthermore, TNF-α and NF-κB expression were decreased with infliximab administrated groups similar to control group. In conclusion, we suggest that infliximab have protective roles on CIN.
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Affiliation(s)
- Murat Saritemur
- Department of Emergency Medicine; Ataturk University Faculty of Medicine, 25240 Erzurum Turkey
| | - Harun Un
- Department of Biochemistry; Agri Ibrahim Cecen University Faculty of Pharmacy, 04100 Agri Turkey
| | - Elif Cadirci
- Department of Pharmacology; Ataturk University Faculty of Pharmacy, 25240 Erzurum Turkey.
| | - Emre Karakus
- Department of Pharmacology; Ataturk University Faculty of Veterinary Medicine, 25240 Erzurum Turkey
| | - Erol Akpinar
- Department of Pharmacology; Ataturk University Faculty of Medicine, 25240 Erzurum Turkey
| | - Zekai Halici
- Department of Pharmacology; Ataturk University Faculty of Medicine, 25240 Erzurum Turkey
| | - Rustem Anil Ugan
- Department of Pharmacology; Ataturk University Faculty of Medicine, 25240 Erzurum Turkey
| | - Adem Karaman
- Department of Radiology; Ataturk University Faculty of Medicine, 25240 Erzurum Turkey
| | - Hasan Tarik Atmaca
- Department of Pathology; Kırıkkale University Faculty of Veterinary, 71450 Kirikkale Turkey
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Karaman A, Aydin H, Geçkinli B, Göksu K. The deletion 22q13 syndrome: a new case. Genet Couns 2015; 26:53-60. [PMID: 26043508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The deletion 22q13.3 syndrome (Phelan-McDermid syndrome) is a chromosome microdeletion syndrome characterized by neonatal hypotonia, global developmental delay, normal to accelerated growth, absent to severely delayed speech, and minor dysmorphic features. Common physical traits include long eye lashes, large or unusual ears, relatively large hands, dysplastic toenails, full brow, dolicocephaly, full cheeks, bulbous nose, and pointed chin. Behavior is autisticlike with decreased perception of pain and habitual chewing or mouthing. The loss of 22q13.3 can result from simple deletion, translocation, ring chromosome formation and less common structural changes affecting the long arm of chromosome 22, specifically the region containing the SHANK3 gene. The present case was referred at the age of 8 months because of delayed psychomotor development, hypotonia and autistic features. Clinical examination showed a small forehead, long eyelashes, epicanthal folds and lowset ears, large and broad hands and feet with short terminal phalanges. He had no eye contact and could not sit without support.
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Karaman A, Aydin H, Göksu K. Concomitant omphalocele, anencephaly and arthrogryposis associated with trisomy 18. Genet Couns 2015; 26:77-79. [PMID: 26043511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
MESH Headings
- Abnormalities, Multiple/diagnostic imaging
- Abnormalities, Multiple/genetics
- Abortion, Induced
- Adult
- Anencephaly/diagnostic imaging
- Anencephaly/genetics
- Arthrogryposis/diagnostic imaging
- Arthrogryposis/genetics
- Chromosomes, Human, Pair 18/diagnostic imaging
- Chromosomes, Human, Pair 18/genetics
- Female
- Hernia, Umbilical/diagnostic imaging
- Hernia, Umbilical/genetics
- Humans
- Pregnancy
- Trisomy/genetics
- Trisomy 18 Syndrome
- Ultrasonography, Prenatal
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Aydin BH, Arisoy R, Simsek H, Erdogdu E, Geckinli B, Karaman A, Demirci O. CO-OCCURRENCE OF NEURAL TUBE DEFECT, THORACAL DEFECT AND OMPHALOCELE: A RARE CASE AND REVIEW OF THE LITERATURE. Genet Couns 2015; 26:253-257. [PMID: 26349198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Demirci O, Yavuz T, Arisoy R, Pekin O, Acar H, Aydin H, Cetinkaya A, Karaman A, Erdoğdu E, Kumru P. AGENESIS OF THE DUCTUS VENOSUS--A CASE WITH NOONAN SYNDROME. Genet Couns 2015; 26:373-376. [PMID: 26625673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Geckinli BB, Aydin H, Karaman A, Delil K, Simsek H, Gokmeydan E, Turkdogan D. CLINICAL REPORT OF A PATIENT WITH DE NOVO TRISOMY 12q23.1q24.33. Genet Couns 2015; 26:393-400. [PMID: 26852509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We report a patient with a rare de novo duplication of 12q23.1-12q24.33 region with a 32.7 Mb gain, having similar features seen in previously reported isolated cases of duplications of the 12q23q24 region, such as growth retardation, neuromotor retardation, corpus callosum agenesis, dysmorphic features such as, hypertelorism, epicanthus, flat nasal bridge, low-set small ears, down-turned corners of the mouth, micrognathia, cryptorchidism and limb anomalies such as pes plano valgus, prominent heels and overriding toes. Our patient has Noonan-like features, such as short stature, short neck, epicanthal folds, ptosis of eyelids, hypertelorism, pectus excavatum, widely spaced nipples and cryptorchidism. Duplication of PTPN11 gene has been postulated as a mechanism for the Noonan syndrome. Phenotypic features and the genes involved in this region are important to further delineate the 12q23q24 phenotype.
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Durur-Subasi I, Durur-Karakaya A, Karaman A, Demirci E, Alper F, Yılmazel-Ucar E, Acemoglu H, Akcay MN. Value of MRI sequences for prediction of invasive breast carcinoma size. J Med Imaging Radiat Oncol 2014; 58:565-8. [DOI: 10.1111/1754-9485.12205] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 06/06/2014] [Indexed: 12/30/2022]
Affiliation(s)
- Irmak Durur-Subasi
- Department of Radiology; Ataturk University, School of Medicine; Erzurum Turkey
| | - Afak Durur-Karakaya
- Department of Radiology; Erzurum Regional Research and Training Hospital; Erzurum Turkey
| | - Adem Karaman
- Department of Radiology; Ataturk University, School of Medicine; Erzurum Turkey
| | - Elif Demirci
- Department of Pathology; Ataturk University, School of Medicine; Erzurum Turkey
| | - Fatih Alper
- Department of Radiology; Ataturk University, School of Medicine; Erzurum Turkey
| | - Elif Yılmazel-Ucar
- Department of Chest Diseases; Ataturk University, School of Medicine; Erzurum Turkey
| | - Hamit Acemoglu
- Department of Medical Education; Ataturk University, School of Medicine; Erzurum Turkey
| | - Mufide Nuran Akcay
- Department of General Surgery; Ataturk University, School of Medicine; Erzurum Turkey
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Araz O, Demirci E, Ucar EY, Calik M, Karaman A, Durur-Subasi I, Orsal E, Subasi M, Daloglu F, Akgun M. Roles of Ki-67, p53, transforming growth factor-β and lysyl oxidase in the metastasis of lung cancer. Respirology 2014; 19:1034-9. [PMID: 24995672 DOI: 10.1111/resp.12345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/28/2014] [Accepted: 05/01/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Most lung cancer (LC) patients have metastatic disease at time of diagnosis, which influence the treatment regimen and is the most important prognostic factor. The main purpose of our study was to evaluate the relationship between cell proliferation (Ki-67 label index), p53, transforming growth factor-β (TGF-β) and lysyl oxidase (LOX), and the metastatic stages of different lung cancers. The secondary aim was to correlate these parameters with the standardized uptake value (SUVmax) of the primary lesion during positron emission tomography-computed tomography (PET-CT). METHODS Eighty-five treatment-naive patients with LC were enrolled. All patients were examined with PET-CT. Ki-67, p53, TGF-β and LOX were evaluated histopathologically. RESULTS Small cell lung cancer (SCLC) showed the most intense staining in all parameters. A well-differentiated adenocarcinoma (AC) demonstrated a more diffuse and intense staining than squamous cell carcinoma (SCC). There was no statistically significant relationship between the four parameters and metastases of SCLC and SCC. However, a significant relationship between TGF-β, LOX and metastatic AC was demonstrated with regards to diffusivity and intensity. p53 and Ki-67 did not show a significant relationship. No correlation between SCLC and SCC and SUVmax was found. However, in AC, the diffusivity and intensity of the LOX and p53 staining showed a statistically significant relationship to the SUVmax. CONCLUSIONS LOX and TGF-β may play roles in metastatic AC. LOX and TGF-β may become markers of metastatic disease and inhibition could be explored for treatment.
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Affiliation(s)
- Omer Araz
- Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey
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Araz O, Ucar EY, Meral M, Yalcin A, Acemoglu H, Dogan H, Karaman A, Aydin Y, Gorguner M, Akgun M. Frequency of Class I and II HLA alleles in patients with lung cancer according to chemotherapy response and 5-year survival. Clin Respir J 2014; 9:297-304. [PMID: 24720676 DOI: 10.1111/crj.12143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2013] [Revised: 02/13/2014] [Accepted: 04/04/2014] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Lung cancer is the most common cause of cancer death in the world, and the most common type is non-small-cell lung cancer (NSCLC). At present, surgical resection, chemotherapy, and radiation therapy are the main treatments for patients with NSCLC, but unfortunately outcome remains unsatisfactory. OBJECTIVES This study aimed to determine whether Class I and II histocompatibility leukocyte antigen (HLA) alleles are related with response to chemotherapy and survival of lung cancer. METHODS A total of 65 NSCLC patients (56 men and 9 women, mean age 58.4 ± 11 years) were included in the study. Patient groups were compared with a control group of 88 unrelated healthy kidney or bone marrow donors in order to clearly identify susceptible and protective HLA alleles in lung cancer. Target lesions and tumor response were assessed using the Response Evaluation Criteria for Solid Tumors (RECIST) guidelines. Results were classified into two groups: complete-partial response and stable-progressive disease. RESULTS We found that expression of HLA-A32, HLA-B41, HLA-B57, HLA-DRB1*13, and HLA-DQ5 were more frequent in the complete and partial response groups to chemotherapy than in the control group. The frequency of HLA-A11, HLA-A29, HLA-BW6, HLA-CW3, HLA-DR1*1, and HLA-DRB1*3 were determined to be higher in the stable and progressive disease groups taking chemotherapy than in the control group. Additionally, expressions of HLA-A2 and HLA-B49 were statistically related with 5-year survival. CONCLUSION Our results suggested that expressions of HLA-BW6 and HLA-DRB1*13 alleles may be predictable markers for response to chemotherapy in lung cancer patients.
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Affiliation(s)
- Omer Araz
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Elif Yilmazel Ucar
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Mehmet Meral
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Aslıhan Yalcin
- Department of Pulmonary Diseases, Marmara University, Istanbul, Turkey
| | - Hamit Acemoglu
- Department of Medical Education, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Hasan Dogan
- Department of Medical Biology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Adem Karaman
- Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Yener Aydin
- Department of Thoracic Surgery, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Metin Gorguner
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Metin Akgun
- Department of Pulmonary Diseases, School of Medicine, Ataturk University, Erzurum, Turkey
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Aydin H, Yanik S, Tug E, Ahsen H, Geckinli B, Senol S, Karaman A, Yilmaz F, Boran C. Craniorachischisis, gastroschisis, and a branchial sinus defect: a case report. Genet Couns 2014; 25:237-240. [PMID: 25059025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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43
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Karaman A, Kahraman M, Bozdoğan E, Alper F, Akgün M. [Diffusion magnetic resonance imaging of thorax]. Tuberk Toraks 2014; 62:215-230. [PMID: 25492819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
Although magnetic resonance imaging (MRI) of Thorax is only useful for morphological evaluation, currently we can use it for functional evaluation such as diffusion weighted imaging. Currently, we can obtain higher quality images because of new technologies such as software that decrease motion artefact, use of multi-channel, parallel imaging and fast sequences. Many promising results of thorax MRI have been published. It may also be an alternative to thorax computed tomography in some indications without radiation exposure risk. In this review, we evaluated current literature on use of DWI MRI examination on the pathologies of lungs and mediastinum and aimed to present what kind of information is provided on recognition and characterization of thoracic pathologies.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.
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Geckinli BB, Aydin H, Karaman A. A patient with duplication (7)(p15.3p22.3) and deletion (7)(p22.3pter) characterized by array-CGH. Genet Couns 2014; 25:405-412. [PMID: 25804019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We report a patient with neurodevelopmental delay, hypotonia, congenital cardiac anomaly and dysmorphic features such as macrocephaly, a large anterior fontanel, prominent forehead, short neck, downslanted and short palpebral fissures, hypertelorism, wide nasal bridge, straight, thin nose with asymmetric narrow inverted nostrils, micrognathia, low-set dysplastic ears. 7p15.3-p22.3 duplication and a 7p22.3-pter deletion were characterized by array-CGH analysed after karyotyping and FISH studies. The patient's distinctive features are consistent with the phenotypic features of 7p duplication. The genes involved in these regions are discussed for their possible relation to our patient's phenotype.
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Araz O, Demirci E, Yilmazel Ucar E, Calik M, Pulur D, Karaman A, Yayla M, Altun E, Halici Z, Akgun M. Comparison of reducing effect on lung injury of dexamethasone and bosentan in acute lung injury: an experimental study. Multidiscip Respir Med 2013. [DOI: 10.4081/mrm.2013.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Different medical therapies are employed in acute lung injury (ALI) but there is still a debate about the efficacy of these drugs. Among these therapies steroids are clinically applied and bosentan is experimentally studied. The aim of this study was to evaluate the efficacy of these two drugs to treat inflammation in ALI by histopathological comparison. Methods: The five experimental groups (n = 5 per group) were: saline control (Group I); lipopolysaccharide (LPS) + saline (Group II); LPS + dexamethasone (Group III); LPS + 50 mg/kg bosentan (Group IV); and LPS + 100 mg/kg bosentan (Group V). Bosentan was administered orally one hour before and 12 hours after LPS treatment. Dexamethasone was administered intraperitoneally in three doses of 1 mg/kg; one dose was co-administered with LPS and the other two doses were given respectively 30 minutes before and after LPS treatment. Vasodilation-congestion, hemorrhage, polymorphonuclear leukocyte (PMN) infiltration, mononuclear leukocyte (MNL) infiltration, alveolar wall thickening, alveolar destruction/emphysematous appearance, and focal organization were the parameters used as criteria for evaluating inflammation and efficacy of treatment. Results: Compared to the LPS-only group (Group II), dexamethasone treatment (Group III) resulted in significant improvements in vasodilation-congestion, hemorrhage, PMN and MNL infiltration, alveolar wall thickening and emphysematous areas. Treatment with 50 mg/kg dose of bosentan (Group IV) also resulted in significant improvements in hemorrhage, PMN and MNL infiltration, alveolar wall thickening and alveolar destruction. Reducing lung injury and reparative effects of 100 mg/kg bosentan were significant in all parameters. Conclusions: Bosentan is as effective as dexamethasone for treating lung injury in ALI. Bosentan at 100 mg/kg can be recommended as a first treatment choice based on its significant reducing lung injury and reparative effects.
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Araz Ö, Karaman A, Ucar EY, Bilen Y, Durur Subası I. DCE-MRI findings of invasive aspergillosis in patient with acute myeloid leukemia. The Clinical Respiratory Journal 2013; 8:248-50. [DOI: 10.1111/crj.12061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Accepted: 09/29/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Ömer Araz
- Department of Pulmonary Disease; Ataturk University; Erzurum Turkey
| | - Adem Karaman
- Department of Radiology; Ataturk University; Erzurum Turkey
| | | | - Yusuf Bilen
- Department of Hematology; Ataturk University; Erzurum Turkey
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Yilmaz İ, Karaman A, Vardi N, Cetin A, Erdemli E. Effects of organic apricot on liver regeneration after partial hepatectomy in rats. Transplant Proc 2013; 45:2455-60. [PMID: 23953562 DOI: 10.1016/j.transproceed.2013.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/05/2013] [Accepted: 04/23/2013] [Indexed: 02/09/2023]
Abstract
BACKGROUND The present study investigated the effects of (sun-dried organic apricot/SDOA) supplementation in chow on liver regeneration after partial hepatectomy/(PH) in rats. METHOD In this study, 28 female rats were randomized into four groups. On the 7th day of the study, group 1 underwent laparoscopic intervention while a PH was performed on the other three cohorts. On day 28, all rats were humanely killed. Blood and liver tissue samples were subjected to biochemical determinations, histological examinations, and measurement of tissue oxidative stress enzyme activity. RESULTS Serum levels of alanine transaminase (ALT), alkaline phosphatase (ALP), and liver tissue glutathione (GSH) activities were affected by PH and/or SDOA consumption (P < .05). Moderately staining cell counts in group 4 were significantly different from the other three groups (P < .05). However, no significant differences were detected among all groups in regard to aspartate aminotransferase (AST) serum levels or liver tissue superoxide dismutase (SOD), malondialdehyde (MDA), catalase (CAT) or glutathione peroxidase (GSHpx) activities (P < .05). CONCLUSION The 5% SDOA supplementation over a 21-day feeding period showed a beneficial effect on liver regeneration in rats, as reflects by Ki-67 finding although there was no change in ALT or ALP or in liver tissue GSH activity.
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Affiliation(s)
- İ Yilmaz
- Department of Pharmacology, İnonu University, Malatya/Turkey.
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Binici DN, Karaman A, Coşkun M, Oğlu AU, Uçar F. Genomic damage in patients with type-2 diabetes mellitus. Genet Couns 2013; 24:149-156. [PMID: 24032284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
DNA damage seems to play a role in the pathogenesis of type-2 diabetes mellitus (DM2) and its complications. Several in vitro assays have been used to measure the DNA damage. In the present study, we aimed to investigate the frequency of sister chromatid exchange (SCE) and micronuclei (MN) in DM2 patients compared with healthy controls. SCE and MN tests were carried out with the blood-cell cultures from 50 DM2 patients and 30 healthy, age- and sex-matched control subjects. The mean age of the DM2 patients was 58.12 +/- 13.39 years, with a mean duration of the diabetes of 5.40 +/- 4.32 years. The mean level of HbAlc of the DM2 patients was 8.93 +/- 2.56. Patients with DM2 showed a higher frequency of SCE compared with controls (7.11 +/- 1.14 and 4.96 +/- 0.92, p < 0.001). Furthermore, the SCE frequency was positively correlated with the plasma HbA1c level (p < 0.05), but there was no significant correlation between the duration of diabetes and SCE. On the other hand, our result showed a MN frequency significant increase in DM2 patients (3.45 +/- 1.01 per 1000 cells) relative to that of the control group (1.79 +/- 0.67 per 1000 cells) (p < 0.001), but there was no significant correlation between the duration of diabetes, HbA1c and MN. In conclusion, these results suggest that DM2 is a condition with genomic instability characterized by an increased level of SCE and MN. Hyperglycemia-induced oxidative stress may be the underlying factor of the increased SCE and MN frequency.
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Affiliation(s)
- D N Binici
- Department of Internal Medicine, Erzurum Training and Research Hospital, Erzurum, Turkey
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Aydin H, Arisoy R, Geckinli B, Erdogdu E, Karaman A, Gokmeydan E, Pekin O, Tugrul S, Yorganci C. Tetrasomy 12p presenting with long appendix: a prenatal case. Genet Couns 2013; 24:439-440. [PMID: 24551989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Abstract
Echinococcus alveolaris (E. alveolaris) (multi-localaris) is a parasitic agent that commonly affects the liver and poses as a solid mass. In contrast to Echnicoccus granulosus, E. alveolaris tends to invade adjacent structures rather than displace and compress them. Haematogenous dissemination to other organs such as the lungs, brain, or bone is rare. In this case, we report on a 34-year old woman with a history of liver segmentectomy due to E. alveolaris infestation and the disease disseminated to the lungs. Computed tomography and magnetic resonance imaging showed multiple opacities and mixed signal intensities in the lungs, mimicking metastatic disease. The biopsy proved that the lesions were a result of metastasis of E. alveolaris.
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Affiliation(s)
- Adem Karaman
- Department of Radiology, School of Medicine, Ataturk University, Erzurum, Turkey.
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