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Öğe CT assessment of main pulmonary artery diameter(Turkish Soc Radiology, 2008) Karazincir, Sinem; Balcı, Ali; Seyfeli, Erguen; Akoglu, Sebahat; Babayigit, Cenk; Akgul, Ferit; Yalcin, FatihPURPOSE The purpose of this study was to determine the normal range of the main pulmonary artery diameter (MPAD) by computed tomography (CT) in persons with normal pulmonary artery pressure, and then to evaluate the relationship of the diameter with age, gender, and body surface area (BSA). MATERIALS AND METHODS Between October 2005 and June 2007, among patients who had previously undergone a contrast-enhanced thorax CT scan, 112 persons (47 females, 65 males) without pulmonary pathology were selected for the study. A patients had normal mean pulmonary artery pressure. The widest diameter perpendicular to the long axis of the main pulmonary artery was measured at the pulmonary artery bifurcation level. The outer limits of the contrast were used to determine vessel diameter. RESULTS Pulmonary artery diameters showed a homogeneous distribution; the CT-determined mean pulmonary artery diameter was 26.6 +/- 2.9 mm. The mean MPAD in males was 27 2,8 mm, and 25.9 +/- 3.0 mm in females. This difference was considered to be statistically significant (P = 0.048). There was a significant relationship between the MAPD and age and BSA (P = 0.043, P < 0.001). CONCLUSION The present study demonstrated that in individuals with normal pulmonary artery pressure, the upper limit of the MPAD is 32.6 mm and that MPAD is well-correlated with BSA.Öğe A Delayed Diagnosis of a Patient with Bronchiectasis: Swyer-James/MacLeod Syndrome(Aves, 2007) Karazincir, Sinem; Babayigit, Cenk; Balcı, Ali; Akoglu, Sebahat; Seyfeli, Ergun; Sumbas, HaldunSwyer-James/MacLeod Syndrome is a rare disease which is characterized by unilateal hyperlucent lung due to hypoplasia of its pulmonary artery. A non-smoker, 57 years old female patient admitted to our clinic with cough, sputum production and fever. Her medical history revealed that these symptoms has been recurrent since her childhood. Furthermore she had been followed up with as a patient of chronic bronchitis or bronchiectasis outside of our clinic so far. Physical examination revealed diminished respiratory sounds and coarse crackles onmiddle and lower zones of left hemithorax. Chest X Ray showed hyperluceny and volume loss of the left lung and bronchiectasis at the left lower zone. Computerized and High Resolution Computerized Tomography revelaed hypoplasia of left pulmonary artery with reduced diameters of its branches, hyperlucent left lung and cyctic bronchiectasis in left lower, and superior and lingular segments of the left upper lobes. Colored Doppler Echocardiography showed hypoplasia of the left pulmonary artery and enlargement of the main pulmonary artery. Swyer-James/MacLeod Syndrome is diagnosed in childhood or early adulthood of most of the cases. We present this case to emphasize the delayed diagnosis until the age of 57 although she had been investigated several times because of her recurrent symptoms since her childhood and to emphasize considering this syndrome especially when a hyperlucent lung was detected on chest X ray.Öğe Erratum: Giant left atrium mimicking a right thoracic mass: Case report (Journal of the American Geriatrics Society (2006) 54, (183-184))(2006) Seyfeli, Ergun; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Seydaliyeva, Tunzale; Yalcin, Fatih; Duru, Mehmet[No abstract available]Öğe The evaluation of early pulmonary involvement with high resolution computerized tomography in asymptomatic and non-smoker patients with rheumatoid arthritis(Turkish Assoc Tuberculosis & Thorax, 2009) Karazincir, Sinem; Akoglu, Sebahat; Guler, Hayal; Balcı, Ali; Babayigit, Cenk; Egilmez, ErtugrulTo investigate pulmonary involvement by high resolution computerized tomography (HRCT) in patients with rheumatoid arthritis (RA) who are asymptomatic and lifelong non-smoker. Twenty-five patients with RA who are asymptomatic and lifelong non-smoker were included in the study. After clinical and laboratory investigations, plain chest X-rays, pulmonary function tests (PFT) and HRCT were performed. End expiratory HRCT slices were obtained for air trapping. Chest X-ray, PFT and HRCT findings showed 12%, 16%, 48% abnormalities, respectively. Interstitial involvement was the most common finding on HRCT (36%) and followed by air trapping (20%). Bronchiectasis, pulmonary nodule, and pleural disease were seen in 16%, 12%, and 12% of patients, respectively. None of patients had emphysema and honeycomb pattern. There was no statistically significant correlation between HRCT findings and disease activity criteria, RF positivity, PFT results and duration of the disease. Our study shows that pulmonary involvement is not always together with respiratory symptoms and impaired pulmonary function in patients with RA. New studies are needed which investigating the effects of radiologically detected lung involvement on prediction of survival and treatment choice in asymptomatic and nonsmoker RA patients.Öğe Ex Vivo Tracheal Mucociliary Clearance in Rats: Comparisons of Nebulization versus Irrigation with Lactated Ringer and Saline Solutions(Bmc, 2009) Okuyucu, Semsettin; Akoglu, Ertap; Babayigit, Cenk; Akoglu, Sebahat; Dagli, SafakObjective: This study was performed to compare the effects of isotonic saline, hypertonic saline (buffered/nonbuffered), and lactated Ringer irrigation and distilled water nebulization on mucociliary clearance in ex vivo rats. Design: Experimental study. Setting: Tertiary otolaryngology care centre. Methods: Thirty rat tracheas were achieved from 15 rats by dividing the trachea longitudinally into two equal parts. Main Outcome Measures: Mucociliary transport velocity was measured by direct observation of particle placed on the lower end of the trachea after irrigation or nebulization. Results: Significant improvement in mucociliary clearance was found with isotonic saline (p = .002), buffered hypertonic saline (p = .018), lactated Ringer (p = .000), and nebulized distilled water (p = .000) when compared with nonbuffered hypertonic saline. Conclusion: Lactated Ringer solution is better than saline solution at enhancing mucociliary clearance, but nebulized distilled water is superior to the tested irrigation solutions in rat tracheal epithelium.Öğe Giant left atrium mimicking a right thoracic mass: Case report (vol 54, pg 183, 2006)(Blackwell Publishing, 2006) Seyfeli, Ergun; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Seydaliyeva, Tunzale; Yalcin, Fatih; Duru, Mehmet[Abstract Not Available]Öğe The Relationship between Patient Age and Sensitivity to Known Risk Factors for Asthma Attacks(Bilimsel Tip Publishing House, 2013) Dogru, Sibel; Kanat, Fikret; Ozer, Faruk; Maden, Emin; Akoglu, Sebahat; Babayigit, CenkOBJECTIVE: The characteristics of patients hospitalised for an asthma attack were evaluated to delineate the impact of age on sensitivity to risk factors for this condition. MATERIAL AND METHODS: Eighty patients hospitalised for an asthma attack were included in this cross-sectional study. Patients were divided into two age groups; younger than 65-years-old (52.5 +/- 7.6 years, n= 36) and older than 65-years-old (72.5 +/- 5.2 years, n=44). A questionnaire was used to collect data on demographics, initial age and duration of asthma, atopy, atopic diseases, drug and food allergies, additional diseases, treatments during the previous 1 and 3 months, cause of attacks, duration of hospital stay, number of emergency visits and hospitalisation due to asthma over the last year, and all past hospital stays. Pulmonary function tests were performed upon admittance and discharge, and parameters of arterial blood gases were recorded. RESULTS : The severity of asthma attacks was greater in the older cohort of patients with risk factors including osteoporosis, positive skin test for mould, or theophylline use in the previous month. Independent of these variables, the severity of attacks was greater in patients over the age of 65. Irregular treatments in both age groups were noted over the previous one and three months. CONCLUSION: Theophylline use, mould sensitivity and biomass exposure in elderly patients with asthma should be questioned more carefully and protective measures taken to avoid these risks in keeping with the recommended guidelines.Öğe Retropharyngeal hematoma as a complication of anticoagulation therapy(Vendome Group Llc, 2008) Akoglu, Ertap; Seyfeli, Erguen; Akoglu, Sebahat; Karazincir, Sinem; Okuyucu, Emsettin; Dagli, Ali SafakReports in the literature of retropharyngeal hematoma as a complication of anticoagulation therapy are rare. When this complication does occur, it can become life-threatening if the airway is compromised. However, no consensus exists as to which approach-intubation, tracheotomy, or conservative therapy-is best for managing the airway in these cases. We report a case of retropharyngeal hematoma that occurred as a sequela to a trivial blunt trauma in a 48-year-old man who had been undergoing anticoagulation therapy with warfarin. The hematoma had caused airway obstruction, and the patient was hospitalized. He was treated conservatively, and the hematoma slowly resolved over the course of 2 weeks. On the basis of our experience and the findings of our literature review, we suggest that conservative management can be initiated for small nonexpanding hematomas that do not seriously compromise the airway. Securing the airway with intubation or tracheotomy should be reserved for patients who are in serious respiratory distress; the choice between intubation and tracheotomy should be made on an individual basis.Öğe Right ventricular diastolic abnormalities in rheumatoid arthritis and its relationship with left ventricular and pulmonary involvement. A tissue Doppler echocardiographic study(Springer, 2006) Seyfeli, Ergun; Guler, Hayal; Akoglu, Sebahat; Karazincir, Sinem; Akgul, Ferit; Saglam, Hayrettin; Seydaliyeva, TunzaleObjectives To investigate right ventricular diastolic function in rheumatoid arthritis (RA) and its relationship with left ventricular and pulmonary involvement. Methods Thirty-five RA patients and 30 healthy subjects were submitted to conventional Doppler (CE) and tissue Doppler echocardiography (TDE) to assess left and right systolic and diastolic function and to estimate maximal arterial systolic pulmonary pressure (PAP). To detect pulmonary involvement, pulmonary function tests and high-resolution computed tomography (HRCT) scans were performed in all RA patients. Results An abnormal RV filling, as expressed byan inverted tricuspid (Tr.) E/A ratio, was detected in 12 (34%) of the 35 RA patients and in 2 (7%) of the 30 controls (P < 0.004). If compared to CE findings, prevalence of RV diastolic abnormalities were found higher in patients with RA by TDE (RV annulus Em/Am ratio < 1 (in 31 (89%) of 35 patients) (P=0.002). Twenty-two (63%) of 35 patients had abnormal HRCT findings. Pulmonary involvement with pulmonary hypertension (PHT) (36 +/- 5 mmHg) was detected in 10 (29%) of 35 RA. In this group, increase of RV annulus and basal Am wave, decrease of Tr. E/A ratio and RV annulus Em/Am ratio were statistically significant compared to RA (12 (34%) of 35) patients with pulmonary involvement who had normal PAP (19 +/- 5 mmHg), (P=0.014, P=0.006, P=0.015, P=0.049, respectively). Conclusions This study points out an impaired RV filling in a significant part of RA patients without overt heart failure. Impairment of RV diastolic function may be a predictor of subclinic myocardial and pulmonary involvement in patients with RA.Öğe Tracheobronchial Anomaly and Variants Detected by Bronchoscopy(Bilimsel Tip Publishing House, 2006) Akoglu, Sebahat; Ucan, Eyup Sabri; Celik, Gulperi; Sener, Gulper; Sevinc, Can; Kilinc, Oguz; Itil, OyaIn the past, tracheobronchial anomaly and variants (TBA) have been reported in 1-12% of the patients who underwent bronchography or bronchoscopy. In addition to various anatomic variants, tracheal bronchus and accessory cardiac bronchus may be seen rarely. The objective of our study was to investigate the patients with TBA diagnosed by bronchoscopy and describe their clinical characteristics. The reports of all bronchoscopies performed in Dokuz Eylul University Hospital Department of Pulmonary Diseases between 1992 and 2002 were reviewed and the patients with TBA were collected. Data about clinical and radiologic findings of the patients with TBA were recorded. In 72 out of 6732 bronchoscopies (1.06%) TBA was detected. There were 49 males (68%) and mean age was 57.8 (range, 26 to 89). Tracheal bronchus and accessory cardiac bronchus were detected in 16 (0.2%) and four (0.05%) patients, respectively. Most of the TBA were localized at the right upper lobe bronchus (67.07%). In eight patients (11.1%) there were more than one TBA. One patient had bilateral TBA including accessory cardiac bronchus and tracheal bronchus of the left lower lobe bronchus. In two patients, there were another airway anomalies including Mac Leod's syndrom and pulmonary secestration, whereas one patient had diaphragmatic hernia. TBA is usually asymptomatic and an accidental finding on bronchoscopic examination. However, tracheal bronchus and accessory cardiac bronchus may result in cough, hemoptysis or recurrent pneumonia. Therefore, knowledge of bronchial anomaly and variants is essential for distinguishing pathological findings and proper bronchoscopic and clinical diagnosis.Öğe Tuberculous pleurisy after tumour necrosis factor-a antagonist usage: Case report(Turkish Assoc Tuberculosis & Thorax, 2008) Akoglu, Sebahat; Babayigit, Cenk; Karazincir, Sinem; Balcı, Ali; Hanta, IsmailA thirty-six year old male patient presented with dyspnea, right-sided chest pain, night sweats and intermittent fever. He has a history of ankylosing spondylitis treated with tumour necrosis factor-alpha (TNF-alpha) antagonist (infliximab). Computed tomography of the chest showed mediastinal lymphadenopathy, right-sided pleural effusion, and atelectasis. The pleural fluid was exudative with lymphocyte dominance. Closed pleural biopsy was nondiagnostic. The adenosine deaminase level of the pleural fluid was 110 U/L. In light of these findings, the patient was diagnosed as tuberculous pleurisy and antituberculous treatment was given. After one month, pleural fluid was markedly reduced.
