The presence of promatrix metalloproteinase-3 and its relation with different categories of coal workers' pneumoconiosis.

Extracellular matrix formation (ECM) and remodeling are critical events related to the pathogenesis of pulmonary fibrosis. Matrix metalloproteinases play an essential role in degrading and remodeling the ECM. In this study, we tried to show the presence and correlation of promatrix metalloproteinase-3 (proMMP-3) (the inactive form of metalloproteinase-3) levels in coal workers' pneumoconiosis (CWP) with different categories. The study population consisted of 44 coal miners with CWP (pos CWP). Coal miners without CWP (neg CWP, n = 24) and non-underground personnel (controls, n = 17) were taken as controls. All coal miners were stable and had no systemic infection or disease. Standard posterio-anterior chest radiographs and pulmonary function tests were performed to exclude any diseases other than CWP. Serum proMMP-3 was analysed using the sandwich enzyme-linked immunosorbent assay according to the manufacturer's instructions (The Binding Site, Birmingham, UK). Mean proMMP-3 values of the all three groups were compared and a significant statistical difference obtained (p < 0.001). In addition, a statistically significant difference was found between categories of the disease and proMMP-3 values (p < 0.05). The effects of age, exposure duration and cigarette smoking on proMMP-3 values in coal miners with CWP were investigated. There were no correlations between age, smoking and proMMP-3 values. However, a positive correlation was found between exposure duration and proMMP-3 values (r = 0.447, p = 0.008). In conclusion, proMMP-3 (prostromelysin 1) may play an essential role in degrading and remodeling the ECM in workers with pneumoconiosis. ProMMP-3 may also reflect the stage of pneumoconiosis disease

Antituberculosis drug resistance patterns in two regions of Turkey: a retrospective analysis

BACKROUND: The emergence of Mycobacterium tuberculosis strains resistant to antituberculosis agents has recently received increased attention owing largely to the dramatic outbreaks of multi drug resistance tuberculosis (MDR-TB). METHODS: Patients residing in Zonguldak and Kayseri provinces of Turkey with, pulmonary tuberculosis diagnosed between 1972 and 1999 were retrospectively identified. Drug susceptibility tests had been performed for isoniazid (INH), rifampin (RIF), streptomycin (SM), ethambutol (EMB) and thiacetasone (TH) after isolation by using the resistance proportion method. RESULTS: Total 3718 patients were retrospectively studied. In 1972–1981, resistance rates for to SM and INH were found to be 14.8% and 9.8% respectively (n: 2172). In 1982–1991 period, resistance rates for INH, SM, RIF, EMB and TH were 14.2%, 14.4%, 10.5%, 2.7% and 2.9% (n: 683), while in 1992–1999 period 14.4%, 21.1%, 10.6%, 2.4% and 3.7% respectively (n: 863). Resistance rates were highest for SM and INH in three periods. MDR-TB patients constituted 7.3% and 6.6% of 1982–1991 and 1992–1999 periods (p > 0.05). CONCLUSION: This study demonstrates the importance of resistance rates for TB. Continued surveillance and immediate therapeutic decisions should be undertaken in order to prevent the dissemination of such resistant strains

Does hormonal control obviate positive airway pressure therapy in acromegaly with sleep-disordered breathing?

SummaryIntroductionAcromegaly is a disease in which uncontrolled release of growth hormone occurs after closure of epiphyseal plates, causing changes in the body that can lead to sleep disordered breathing (SDB). No definite guidelines regarding the treatment of SDB in acromegaly are available. In this study, we aimed to investigate the prevalence of SDB in acromegaly and whether hormonal control alters the necessity of positive airway pressure (PAP) therapy in acromegaly patients with SDB.MethodsForty-two acromegaly patients were included in the study and divided into two groups according to disease status, i.e., active or well controlled. All patients underwent polysomnography. Fourteen patients with active acromegaly were diagnosed with SDB and were evaluated for PAP therapy with polysomnography both before and 6 months after disease control was achieved.ResultsSleep-disorder breathing was diagnosed in 22 of 42 patients, 7 of 20 patients with controlled-disease and 15 of 20 patients with active diseases. There were significant reductions in respiratory disturbance index (RDI), apnea index, desaturation index, central apnea number, and rapid eye movement-phase RDI at the control polysomnography. Initially, PAP therapy was indicated in 12 of 14 patients and PAP therapy indication held in 11 patients after acromegaly control was achieved.ConclusionOur study revealed that over half of patients with acromegaly had SDB. Furthermore, SDB severity decreases with acromegaly treatment; however, this decrease does not change the indication for PAP therapy; therefore, PAP therapy should not be delayed in acromegalic SDB patients

The Effect of Obesity on Brain Diffusion Alteration in Patients with Obstructive Sleep Apnea

Purpose. We investigated diffusion alterations in specific regions of the brain in morbid obese, obese, and nonobese OSA patients and searched whether there is a correlation between BMI and ADC values. Materials and Methods. DWIs of 65 patients with OSA were evaluated. The patients were classified according to BMI as morbid obese (n=16), obese (n=27), and nonobese (control, n=22) groups. ADC measurements were performed from 24 different regions of the brain in each patient. The relationship of BMI with ADC values was searched. Results. The ADC values in hypothalamus, insular cortex, parietal cortex, caudate nucleus, frontal white matter, and posterior limb of internal capsule were all increased in obese patients (n=43) compared to control group. The ADC values of midbrain, hypothalamus, orbitofrontal cortex, and parietal cortex were significantly increased in morbid obese compared to obese patients. In obese patients, the degree of BMI was positively correlated with ADC values of orbitofrontal cortex, parietal cortex, and hypothalamus. Conclusion. We observed increasing brain vasogenic edema with increasing BMI, suggesting that the main reason of brain diffusion alteration in patients with OSA could be obesity related

Bleomisin verilen ratlarda plazma ve eritrositlerin oksidan ve antioksidan durumu: Erdostein ve vitamin E'nin koruyucu rolü

Bleomisin toksisitesi, otokatalitik bir mekanizma ile hücresel membranların hasarına yol açan lipid peroksidasyonu ile ilişkilidir ve membran yıkımı toksik, reaktif metabolitlerin üretimi ve hücre ölümüne yol açabilir. Bu nedenle, bleomisin verilen ratlarda reaktif oksijen türleri üretimi, antioksidan enzim aktiviteleri ile erdosteine ve vitamin E'nin olası koruyucu etkilerini araştırdık. Otuzbeş Sprague-Dawley sıçan tedavi almayan kontrol, bleomisin, bleomisin + erdostein ve bleomisin + vitamin E grupları şeklinde rastgele dört gruba ayrıldı. Deney süresi sonunda plazma ve eritrositler elde edilerek tiyobarbitürik asit reaktif maddeler (TBARS) ve nitrik oksit (NO) düzeylerinin yanı sıra süperoksit dismutaz (SOD), katalaz (CAT) ve glutatyon peroksidaz (GSH-Px) aktiviteleri ölçüldü. Bleomisin verilmesi lipid peroksidasyonunun bir göstergesi olan TBARS ve NO düzeylerini artırırken SOD, CAT ve GSH-Px enzim aktivitelerini azaltarak kanda reaktif oksijen türleri artışı ile sonuçlandı. Erdostein ve vitamin E tedavisi, lipid peroksidasyonu artışını anlamlı olarak önlerken; tek başına erdostein, eritrosit ve plazmada SOD, CAT ve GSH-Px aktivitelerindeki azalmayı önledi. Buna göre erdosteinin bu çalışmada kullanılan dozlarda, antioksidan ve serbest radikal temizleyici özellikleriyle, BLM ile uyarılan hematotoksisite üzerine vitamin E'den daha etkili olduğu ileri sürülebilir. Bununla birlikte, uygun dozları bulmak ve konuyu aydınlatmak için erdosteinin farklı dozlarında daha ileri çalışmalar yapılması gerekmektedir.Bleomycin (BLM) toxicity is associated with lipid peroxidation, which is an autocatalytic mechanism leading to oxidative destruction of cellular membranes, and their destruction can lead to the production of toxic, reactive metabolites and cell death. Therefore, we investigated reactive oxygen species production, antioxidant enzyme activities and protective effect of vitamin E and erdosteine in BLM-administrated rats. Thirty-five Sprague-Dawley rats were divided randomly into four groups as untreated control, BLM, BLM+erdosteine and BLM+vitamin E groups. At the end of the treatment, plasma and erythrocytes were obtained and the levels of thiobarbituric acid reactive substances (TBARS) and nitric oxide (NO) as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathion peroxidase (GSH-Px) were measured. Bleomycin administration resulted in the generation of reactive oxygen species in the blood of rats by decreasing the activities of enzymes SOD, CAT and GSH-Px, while increasing the levels of NO and TBARS, an indicative of lipid peroxidation. Erdosteine and vitamin E treatment prevented the increase in the lipid peroxidation. Erdosteine alone significantly prevented the decrease in SOD, CAT and GSH-Px activities in the erythrocyte and plasma. We suggest that erdosteine is more effective on the prevention of BLM-induced hematotoxicity via antioxidant and free radical scavenger properties than vitamin E at the doses used in the present study. However, further studies at different doses of erdosteine are needed to determine most appropriate doses and to clarify the issue

Tansiyon pnömotoraksı taklit eden dev bül

Göğüs grafisinde, tansiyon pnömotoraksı, bir hemitoraksta geniş radyolüsenite ve mediastinal yapıları karşı tarafa itmiş olarak izleriz. Dev bül de geniş radyolüsen görünümü ve mediastinal şift oluşturarak tansiyon pnömotoraksı taklit edebilir. Sunduğumuz olgu dev akciğer bülü olan 35 yaşında bir kadındır. Dev bül acil serviste tansiyon pnömotoraks olarak teşhis edilerek göğüs tüpü takılmıştır. Tansiyon pnömotoraks ile dev bülü ayırt etmek çok zordur. Bu iki çok benzer antitenin tedavileri tamamen farklıdır. Bundan dolayı anamnez, fizik muayene ve radyolojik incelemede, doğru tanı için çok dikkatli olmalıyız.In the chest X-ray, we observe tension pneumothorax (TPX) as wide radiolucent view in a hemithorax and pushing the mediastinal structures contralateral. Giant bulla may mimic TPX with wide radiolucent view and mediastinal shift. The present report includes giant pulmonary bulla in 35-year-old woman. The giant bulla was diagnosed as a TPX in emergency, and chest tube was performed. The differentiation between TPX and a giant bulla may be very difficult. The therapies of these two similar entities are completely different. So that, we must be careful about anamnesis, physical examination and radiology for true diagnosis

A Case of Pulmonary Mucormycosis Presenting with Endobronchial Involvement

Mucormycosis is an opportunistic fungal infection that is rare but has a fatal course, occurs especially in patients with immunodeficiency, and is caused by fungi in the Zygomycetes class. Since the infection is generally caused by inhalation of spores, mostly the paranasal sinuses and lungs are affected. Diabetes mellitus and hematologic malignancies are the most common underlying diseases. It usually initiates like bacterial pneumonia, and its clinical and radiologic findings are nonspecific. Thus, a high index of suspicion is necessary. Combined medical and surgical treatment methods are recommended. We aimed to present a case of pulmonary mucormycosis with a course of endobronchial involvement.Mucormycosis is an opportunistic fungal infection that is rare but has a fatal course, occurs especially in patients with immunodeficiency, and is caused by fungi in the Zygomycetes class. Since the infection is generally caused by inhalation of spores, mostly the paranasal sinuses and lungs are affected. Diabetes mellitus and hematologic malignancies are the most common underlying diseases. It usually initiates like bacterial pneumonia, and its clinical and radiologic findings are nonspecific. Thus, a high index of suspicion is necessary. Combined medical and surgical treatment methods are recommended. We aimed to present a case of pulmonary mucormycosis with a course of endobronchial involvement

Bleomisin verilen ratlarda plazma ve eritrositlerin oksidan ve antioksidan durumu: Erdostein ve vitamin E'nin koruyucu rolü

Bleomisin toksisitesi, otokatalitik bir mekanizma ile hücresel membranların hasarına yol açan lipid peroksidasyonu ile ilişkilidir ve membran yıkımı toksik, reaktif metabolitlerin üretimi ve hücre ölümüne yol açabilir. Bu nedenle, bleomisin verilen ratlarda reaktif oksijen türleri üretimi, antioksidan enzim aktiviteleri ile erdosteine ve vitamin E'nin olası koruyucu etkilerini araştırdık. Otuzbeş Sprague-Dawley sıçan tedavi almayan kontrol, bleomisin, bleomisin + erdostein ve bleomisin + vitamin E grupları şeklinde rastgele dört gruba ayrıldı. Deney süresi sonunda plazma ve eritrositler elde edilerek tiyobarbitürik asit reaktif maddeler (TBARS) ve nitrik oksit (NO) düzeylerinin yanı sıra süperoksit dismutaz (SOD), katalaz (CAT) ve glutatyon peroksidaz (GSH-Px) aktiviteleri ölçüldü. Bleomisin verilmesi lipid peroksidasyonunun bir göstergesi olan TBARS ve NO düzeylerini artırırken SOD, CAT ve GSH-Px enzim aktivitelerini azaltarak kanda reaktif oksijen türleri artışı ile sonuçlandı. Erdostein ve vitamin E tedavisi, lipid peroksidasyonu artışını anlamlı olarak önlerken; tek başına erdostein, eritrosit ve plazmada SOD, CAT ve GSH-Px aktivitelerindeki azalmayı önledi. Buna göre erdosteinin bu çalışmada kullanılan dozlarda, antioksidan ve serbest radikal temizleyici özellikleriyle, BLM ile uyarılan hematotoksisite üzerine vitamin E'den daha etkili olduğu ileri sürülebilir. Bununla birlikte, uygun dozları bulmak ve konuyu aydınlatmak için erdosteinin farklı dozlarında daha ileri çalışmalar yapılması gerekmektedir.Bleomycin (BLM) toxicity is associated with lipid peroxidation, which is an autocatalytic mechanism leading to oxidative destruction of cellular membranes, and their destruction can lead to the production of toxic, reactive metabolites and cell death. Therefore, we investigated reactive oxygen species production, antioxidant enzyme activities and protective effect of vitamin E and erdosteine in BLM-administrated rats. Thirty-five Sprague-Dawley rats were divided randomly into four groups as untreated control, BLM, BLM+erdosteine and BLM+vitamin E groups. At the end of the treatment, plasma and erythrocytes were obtained and the levels of thiobarbituric acid reactive substances (TBARS) and nitric oxide (NO) as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathion peroxidase (GSH-Px) were measured. Bleomycin administration resulted in the generation of reactive oxygen species in the blood of rats by decreasing the activities of enzymes SOD, CAT and GSH-Px, while increasing the levels of NO and TBARS, an indicative of lipid peroxidation. Erdosteine and vitamin E treatment prevented the increase in the lipid peroxidation. Erdosteine alone significantly prevented the decrease in SOD, CAT and GSH-Px activities in the erythrocyte and plasma. We suggest that erdosteine is more effective on the prevention of BLM-induced hematotoxicity via antioxidant and free radical scavenger properties than vitamin E at the doses used in the present study. However, further studies at different doses of erdosteine are needed to determine most appropriate doses and to clarify the issue

Kauçuk fabrikasında çalışan işçilerde solunum semptomlarının değerlendirilmesi

Amaç: Kauçuk fabrikası işçilerdeki mesleksel maruziyetin, solunum sistemine etkilerinin incelenmesi amaçlanmıştır. Metod: Kauçuk fabrikasında çalışan 141 işçinin; anamnez ve fizik muayene sonrası solunum fonksiyon testleri (SFT) değerlendirildi. Bunların sonuçlarına göre astım düşünülen bireylere Peak Expiratory Flow (PEF) takibi ve cilt Prick Testi uygulandı. Bulgular:İşçilerin 116 (%82.3) erkek ve 25 (%17.7) kadındı. Maruziyetin yüksek ve daha az olduğu grup karşılaştırıldığında FEV1/FVC ve FEF2575(%)’deki düşüklük istatistiksel olarak anlamlı bulundu (p<0.05). İşçilerin 9(%6.3)’unda PEF takibinde değişkenliğin % 20’den fazla olduğu bulundu. Sonuç: Sonuç olarak, çalışmamızda kauçuk endüstrisinde toz ve dumanlara maruziyetin çalışmaya bağlı solunumsal semptomlar ve hastalık gelişimi ile ilişki olduğunu göstermektedir. Bu nedenle toz maruziyetinin azaltılması ve sigara bırakma önemli önlemlerdir.Aim: In this study, our objective was to investigate whether there is any relationship between working in the rubber industry and having respiratory symptoms. Method: This study was performed on 141 workers of a rubber factory. Anamnesis, physical examination and pulmonary function tests (PFT) were evaluated. Peak Expiratory Flow (PEF) follow-up and skin Prick Test were administered to the patients according to the results of respiratory system complaints, physical examination and PFT. Result: One hundred and forty one workers who accepted to participate in the study consisted of 116 (82.3%) males and 25 females (17.7%). In the comparison group with greater exposure results were obtained in the normal range, however the parameters of FEV1/FVC and FEF25-75(%) were lower in the greater exposure group. This difference was statistically significant (p<0.05). Variability was greater than 20% in 9 (6.3%) workers in the evaluation of PEF-meter follow-up forms. Conclusion: In conclusion, our study has demonstrated that exposure to dust and smoking in rubber industry seem to be associated with the development of occupational respiratory symptoms and diseases. That&amp;#8217;s why, control of dust exposure and cessation of smoking is important in prevention of this situations