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    Antioxidant effects of bisphosphonates in smoking- induced lung injury in rat model
    (European Respiratory Soc Journals Ltd, 2015) Korkmaz, Celalettin; Yavsan, Durdu Mehmet; Demirbas, Soner; Oltulu, Pembe; Kilinc, Ibrahim; Uyar, Mehmet; Gok, Mehmet
    [Abstract Not Availabe]
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    Comparison of Clinical and Laboratory Findings and Computed Tomography Findings of SARS-CoV-2 Infected Patients Followed-up in a Tertiary University Hospital
    (Galenos Publ House, 2021) Kurt, Esma Kepenek; Kandemir, Bahar; Erayman, Ibrahim; Vatansev, Hulya; Zamani, Adil; Yosunkaya, Sebnem; Demirbas, Soner
    Introduction: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection is a pandemic, a major global health concern. In this study, it was aimed to compare the clinical, laboratory and computed tomography (CT) findings of patients with SARS-CoV-2 infection followed up in our hospital. Materials and Methods: In this study, reverse transcriptase-polymerase chain reaction (RT-PCR) positive patients hospitalized between 01.03.2020-31.05.2020 were retrospectively analyzed. Computed tomography images of the patients were grouped as typical, indeterminate, atypical, and no pneumonia based on the Radiological Society of North America. After recording patient information on SPSS, clinical and laboratory findings of the patients were analyzed by comparing them to CT findings. Results: Among 237 RT-PCR positive patients, 104 (43.9%) were female and 133 (56.1%) were male. The mean age of the patients was 50.46 +/- 17.26 (18-92) years and the mean symptom onset time of the patients was 3.75 +/- 2.72 (median: 3) days. Eighty-seven of the patients (36.7%) had contact stories. Twenty-three (9.7%) patients were healthcare professionals. Of the patients, 49.8% had a comorbid disease. The most common referral complaint was cough with 66.7%. The most common treatment that patients received was hydroxychloroquine (96.2%). Anemia was detected in 61 (25.7%) patients, leukopenia in 104 (43.9%), lymphopenia in 25 (10.5%) and thrombocytopenia in 14 (5.9%). High rates were detected for C-reactive protein (CRP) in 221 (84%) patients, ferritin in 190 (80.2%) patients, D-dimer in 144 (60.8%) patients, fibrinogen in 147 (62%) patients and sedimentation (SED) in 172 (72.6%) patients. Headache was detected higher in patients with typical pneumonia findings in thorax CT (p=0.006). A statistically significant difference wasn't detected between other symptoms and CT findings. Leukocyte and neutrophil counts, SED, CRP, ferritin, D-dimer, fibrinogen, aspartate aminotransferase, and lactate dehydrogenase (p=0.001) levels were observed to be higher in patients with typical pneumonia findings on thorax CT. Conclusion: Some laboratory parameters, especially acute phase reactants, were found to be higher in patients with typical pneumonia on thorax CT compared to patients without pneumonia. In this viral infection, patients should be evaluated together with clinical, laboratory and CT findings.
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    The effect of acute kidney injury on the success of non-invasive ventilation in COPD patients with hypercapnic respiratory failure
    (Kuwait Medical Assoc, 2020) Ince, Mahmut Sami; Teke, Turgut; Karagoz, Ali; Yucel, Fatih; Demirbas, Soner; Korkmaz, Celalettin
    Objective: To investigate the effect of acute kidney injury (AKI) on the success of noninvasive ventilation in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure Design: Retrospective observational cohort study Setting: Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkey Subjects: This clinical study included 55 patients with decompensated COPD: 29 patients with AKI and 26 patients without AKI. Intervention: Demographical data, APACHE II scores, urea and creatinine values before non-invasive mechanical ventilation (NIMV) administration were recorded. Main outcome measures: The effect of AKI on the success of NIMV Results: There was no significant difference between sex, age and baseline respiratory rate of groups. There were statistically significant differences in baseline mean APACHE II score (21.4 +/- 5.3 vs 18.3 +/- 4.6, p=0.028), baseline mean pH (7.23 +/- 0.1 vs 7.30 +/- 0.1, p=0.001), urea (113.7 +/- 43.6 vs 45.2 +/- 13.0, p<0.001) and creatinine values (3.1 +/- 2.0 vs 0.9 +/- 0.3, p<0.001) of Group 1 and Group 2. Logistic regression analysis showed that none of these variable values tested have any effect on NIMV outcomes. Of the baseline variables tested, age (OR: 0.85; 95% CI: 0.69 to 1.07), sex (OR: 1.29; 95% CI: 0.89 to 1.89), baseline respiratory rate (OR: 1.02; 95% CI: 0.92 to 1.14), APACHE II score (OR: 1.03; 95% CI: 0.87 to 1.23), and AKI (OR: 0.79; 95% CI: 0.15 to 4.18) were not related to the outcome of NIMV in the logistic regression. Conclusions: We determined that AKI did not affect the outcome of NIMV in decompensated COPD patients.
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    Effects of comprehensive and intensive pulmonary rehabilitation and nutritional support on quality of life and functional status in patients with chronic obstructive pulmonary disease
    (Sage Publications Ltd, 2020) Korkmaz, Celalettin; Demirbas, Soner; Vatansev, Hulya; Yildirmn, Elif; Teke, Turgut; Zamani, Adil
    Objective To investigate the effects of pulmonary rehabilitation (PR) and combined nutritional support therapy on quality of life (QoL) and functional status in patients with chronic obstructive pulmonary disease (COPD). Methods This pre-and post-intervention prospective exploratory study involved 64 patients with stable stage three to four COPD. Oral nutritional support and personalized diet were combined with an intense and comprehensive PR program. Baseline and 8-week follow-up scores were compared for the 6-minute walk test (6MWT), incremental shuttle walking test (ISWT), St. George's Respiratory Questionnaire (SGRQ), pulmonary function tests (PFT), PImax-PEmax, arterial blood gas (ABG), respiratory rate (RR), handgrip strength, Borg and modified Medical Research Council dyspnoea scale scores and fat-free mass index. Results Significant improvements were found in functional status (6MWT: 86.72 m, ISWT: 76.24 m), QoL (SGRQ total: 13.86), PFT, ABG, RR, dyspnoea, upper extremity muscle strength and hand-body composition. Conclusion Nutritional support with comprehensive and intensive PR can significantly improve physical performance, QoL, dyspnoea and body composition in COPD. The improvement in QoL was greater than that reported in previous studies. Because two modalities were combined in this study, future randomized controlled studies are needed to confirm the extent and contribution of these modalities to the outcomes.
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    Evaluation of Serum Resistin, Visfatin, and Chemerin Levels in Patients with Lung Cancer and Chronic Obstructive Pulmonary Disease
    (Aves, 2020) Goktepe, Mustafa; Korkmaz, Celalettin; Zamani, Adil; Demirbas, Soner; Kilinc, Ibrahim
    OBJECTIVES: Cachexia is an important problem in lung cancer and chronic obstructive pulmonary disease (COPD). Some studies report an association between adipokines and cachexia. Our study aimed to investigate the association of three novel adipokines, resistin, visfatin, and chemerin, with lung cancer and COPD. MATERIALS AND METHODS: 30 patients with non-smallcell lung cancer, 30 patients with COPD, and 30 healthy volunteers were included in the study. Statistically significant weight loss was found in COPD and lung cancer groups compared with that in the control group (p<0.001). Among the biomarkers, only resistin levels were significantly higher in patients with cachexia than in patients without weight loss in all groups (p=0.006). Resistin level was significantly higher in patients with COPD (p=0.002). Visfatin level was significantly higher in the control group (p=0.001). We found that a higher biomass exposure resulted in a significant increase and decrease in resistin (p=0.007) and visfatin levels (p=0.001), respectively, in the patient groups. For all groups, no statistically significant relationship was found between chemerin levels and weight loss or other variables. RESULTS: No significant relationship was found between the biomarkers and lung cancer type, tumor stage, lymph node stage, and metastasis stage. There was no relationship between the biomarkers by tumor, node, and metastasis and COPD stages (p>0.05). We observed no findings strong enough to support the use of these molecules as markers of disease stage or cachexia. CONCLUSION: Resistin, visfatin, and chemerin cannot be used as potential biomarkers for lung cancer or COPD or for disease stage or cachexia.
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    The investigation of levels of endothelial cell-specific molecule, progranuline, clusterin, and human epididymis protein 4 in the differential diagnosis of malignant pleural effusions
    (Lippincott Williams & Wilkins, 2022) Demirbas, Soner; Yerlikaya, Fatma Humeyra; Yosunkaya, Sebnem; Can, Ummugulsum; Celalettin, Korkmaz
    Background:Progranulin (PGRN), endothelial cell-specific molecule-1, clusterin (CLU), and human epididymis protein 4 (HE-4) are novel proteins reported to have diagnostic and prognostic potential in lung cancer. Here, we aimed to identify the markers with high sensitivity and specificity in distinguishing malignant pleural fluids from other pleural fluids. Methods:This prospective, descriptive study was conducted at a medical faculty hospital between 2016 and 2019. The study population consisted of 90 patients <18 years of age with pleural effusion (PE). Levels of pleural fluids of PGRN, endothelial cell-specific molecule-1, CLU, and HE-4 were measured with enzyme-linked immunosorbent assay kits under the manufacturer's manual. Results:Of 90 patients, 54 were men, and 36 were women (mean age 65 +/- 16 years). Of pleural fluids investigated, 23 (25%) and 67 (74%) were transudates and exudates, respectively. Of exudates, while 27 (40%) and 19 (28%) were parapneumonic PE and tuberculous PE, respectively, 20 (29%) were malignant pleural effusion (MPE). Levels of all biomarkers in exudate fluids were found significantly higher than those of transudate fluids. CLU, HE-4, and PGRN levels in MPE were also found significantly higher than benign fluids (P < .05). Cutoff values were achieved by receiver operating characteristics analysis for CLU, HE-4, and PGRN to distinguish between malignant and benign groups. For diagnosis of MPE, the sensitivity and specificity values were found as 0.66 and 0.67 for a cutoff value of CLU of 18.29 mg/L (P = .00), as 0.76 and 0.76 for a cutoff value of HE-4 of 9.33 mg/L (P = .00), and as 0.66 and 0.67 for a cutoff value of PGRN of 105.91 mg/L (P = .001). Conclusion:HE-4 having high sensitivity and specificity can be a potential diagnostic marker in distinguishing between malignant and benign effusions, and these findings can constitute a basis for future research.
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    Tracheobronchial Amiloidosis
    (Aves, 2015) Demirbas, Soner; Kutlu, Orkide; Sakin, Abdullah
    Localized pulmonary amyloidosis without systemic involvement differentiates as nodular parenchymal opacities, diffuse parenchymal opacities, or tracheobronchial amyloidosis (TBA). TBA is a condition mostly seen in males aged up to 50-60 years, accounting for approximately 1% of benign lesions in the tracheobronchial tree. TBA is characterized by the accumulation of the amyloid material comprising immunoglobulin light chain (AL), which are observed as submucosal plaques and/or polypoid tumors; progressive form of tracheobronchial amyloidosis can lead to airway obstruction. Repeated excisional treatments, mainly laser treatment is preferable to open surgery. Here, we have presented the case of a patient diagnosed with the rarely occurring localized TBA.
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    The value of endobronchial ultrasound-guided transbronchial needle aspiration, 18-fluorodeoxyglucose positron emission tomography/computed tomography, and ultrasonography imaging techniques in the diagnosis of mediastinal and/or hilar malignant, anthracotic, and other benign lymph nodes
    (Lippincott Williams & Wilkins, 2021) Korkmaz, Celalettin; Demirbas, Soner; Vatansev, Hulya
    Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a simple, reliable, minimally invasive and effective procedure. However, a surgical technique may be required, if the results are negative. Therefore, there is a need for new studies to increase the diagnostic value of EBUS-TBNA and provide additional information to guide the biopsy in performing the procedure. Here, we aimed to investigate the diagnostic value of EBUS-TBNA and 18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in diagnosis of hilar and/or mediastinal lymph nodes (LNs). It was also aimed to determine the contributions of real-time ultrasonography (USG) images of LNs to distinguishing between the malignant and benign LNs during EBUS-TBNA, and in the diagnosis of anthracotic LNs. Material and Method: In the retrospective study including 545 patients, 1068 LNs were sampled by EBUS-TBNA between January 2015 and February 2020. EBUS-TBNA, 18-FDG PET/CT and images of USG were investigated in the diagnosis of mediastinal and/or hilar malignant, anthracotic and other benign LNs. Results: The sensitivity, specificity, positive predictive value and negative predictive value of EBUS-TBNA were found as 79.5, 98.1, 89.5, and 91.7%, respectively. Mean maximum standardized uptake value (SUVmax) values of 18F-FDG PET/CT were 6.31 +/- 4.3 in anthracotic LNs and 5.07 +/- 2.53 in reactive LNs. Also, mean SUVmax of malignant LNs was 11.02 +/- 7.30 and significantly higher than that of benign LNs. In differentiation of malignant-benign tumors, considering the cut off value of 18F-FDG PET/CT SUVmax as 2.72, the sensitivity and specificity was 99.3 and 11.7%, but given the cut off value as 6.48, the sensitivity, specificity, positive predictive value and negative predictive value was found as 76.5, 64, 20.49, and 78.38% for benign LNs, respectively. Compared LNs as to internal structure and contour features, malignant LNs had most often irregular contours and heterogeneous density. Anthracotic, reactive and other benign LNs were most frequently observed as regular contours and homogeneous density. The difference between malignant and benign LNs was significant. Conclusion: EBUS can contribute to the differential diagnosis of malignant, anthracotic and other benign LNs. Such contributions can guide clinician bronchoscopists during EBUS-TBNA. The triple modality of EBUS-TBNA, 18FDG PET/CT, and USG may increase the diagnostic value in hilar and mediastinal lymphadenopathies.