A systemic inflammatory reaction is a common feature of both sarcoidosis and atherosclerosis. Endothelial-cell specific molecule 1 (endocan) is a marker of vascular pathology which also shows a correlation with inflammation, endothelial dysfunction, and atherosclerosis. The objective of this study was to evaluate the vascular involvement in sarcoidosis using serum endocan levels and brachial artery flow-mediated dilation (FMD), a marker of endothelial dysfunction. We included 53 patients with sarcoidosis without conventional cardiovascular risk factors and 40 healthy controls. Endothelial function was assessed using FMD. Endocan concentrations were measured using a commercially available enzyme-linked immunoassay. Patients with sarcoidosis had significantly higher endocan levels (306 [68] ng/mL vs 269 [73] ng/mL; P = .039) and lower FMD (2.7% [2.3%-3.2%] vs 8% [5%-13%]; P < .001) compared with the healthy group. A negative correlation was found between endocan levels and FMD in the sarcoidosis group ( r = -.325, P < .007). We conclude that sarcoidosis is associated with high levels of endocan and lower FMD values, which may indicate endothelial dysfunction and an early stage of atherosclerosis.

Dyes are known to be a causative agent of occupational asthma in workers exposed to them. We have evaluated respiratory symptoms among textile workers. The study population comprised 106 exposed workers and a control (unexposed) group. Data were collected by a questionnaire. PFTs (Pulmonary Function Test) were performed. Among the exposed workers 36.8% defined phlegm. Respiratory symptoms were not significantly different between two groups. The employment duration of the exposed workers with phlegm was longer than those without phlegm (p = 0.027). The mean % predicted of FEF25–75 of the exposed workers was found to be significantly lower than the control (unexposed) group (p = 0.01). Our study suggests that textile dyeing might cause respiratory symptoms in workers.

Background Obstructive sleep apnea (OSA) is often reported in connection with interstitial lung disease. As yet, there is insufficient data on the association of OSA severity parameters with lung involvement. We purposed to assess the frequency of OSA in our study group and to investigate the relationship between radiological involvement and OSA severity parameters. Material/Methods The study included 79 patients with interstitial lung disease who underwent spirometry, a carbon monoxide diffusion test (DLCO), high-resolution computed tomography, and polysomnography. The data were analyzed using SPSS 22 software. Results Of the 79 patients, 53 patients (67.1%) had OSA, and there was a negative correlation between DLCO and the mean time spent with oxygen saturation levels below 90% (r=−0.686, P =0.001). The Warrick score was used as an indicator of the extent and severity of pulmonary involvement and was positively correlated with the apnea-hypopnea index, oxygen desaturation index, and the mean time spent with oxygen saturation below 90% (r=0.275, P =0.014; r=0.264 P =0.019; r=0.235, P =0.038). Conclusions In our study, a significant relationship was found between the Warrick score and the OSA severity parameters, as determined by polysomnography. Polysomnographic examinations might be useful, especially in patients with a Warrick score greater than 15, to avoid possible complications.

Background: Insulin-like growth factor binding protein-4 (IGFBP-4), a member of the insulin-like growth factor (IGF) family, transports, and regulates the activity of IGFs. The pregnancy-associated plasma protein-A (PAPP-A) has proteolytic activity towards IGFBP-4, and both proteins have been associated with a variety of cancers, including lung cancer. Thus, we aimed to evaluate the use of IGFBP-4 and PAPP-A as potential biomarkers for lung cancer. Methods: Eighty-three volunteers, including 60 patients with lung cancer and 23 healthy individuals, were included in this study. The patients with lung cancer were selected based on their treatment status, histological subgroup, and stage of the disease. Enzyme-linked immunosorbent assays were used to assess the serum levels of IGFBP-4 and PAPPA, whereas the IGF-1 levels were measured using a chemiluminescent immunometric assay. Results: The serum IGFBP-4 levels in all patient groups, regardless of the treatment status and histological differences, were significantly higher than those in the control group (p < 0.005). However, the serum PAPP-A levels in the untreated patient group were found to be higher than those in the control group, but this difference was not statistically significant (p = 0.086). Conclusions: The serum PAPP-A and IGFBP-4 levels are elevated in lung cancer. However, IGFBP-4 may have better potential than PAPP-A as a lung cancer biomarker.

Pulmonary sequestration is defined as a portion of abnormal lung tissue that does not communicate with the tracheobronchial tree through a normally located bronchus and has an abnormal vascular supply [1]. It was first described by Rektorzik in 1861, but the term "sequestration" was introduced by Pryce in 1946 in a 7-case report [2,3]. This extremely rare disorder accounts for 0.16% to 6.4% of all pulmonary congenital malformations [3]. Depending on its location, pulmonary sequestration is generally subdivided into intralobar and extralobar sequestration [4]. Extralobar pulmonary sequestration accounts for 14%-25% of cases [2]. It is most frequently diagnosed in the first 6 months of life, but is seen incidentally, though rarely, in older children and adults [5]. We present an adult case with extralobar pulmonary sequestration. Case ReportA 36-year-old Turkish female, a non-smoker, was admitted to our department with complaints of chest and back pain for five years. Her past history was unremarkable. A chest X-ray (CxR) showed an area of opacity behind the cardiac silhouette in the lower area of the left hemithorax (figure 1). On admission, her resting pulse rate was 86 beats per min., blood pressure 100/70 mmHg, and respiratory rate 18 breaths per min. Her respiratory system and general examinations revealed no significant abnormalities. Full blood count and biochemical tests were normal. Erythrocyte sedimentation rate was 20 mm/h. During hospital stay, the patient was given a course of antibiotics, but opacity in the left lower area persisted. A Computed Tomography (CT) scan of the thorax with intravenous contrast showed a 9 x 7 cm in size ovoid mass with necrosis in the lower left lobe. It revealed two aortic branches directed toward the pulmonary opacity (figure 2), which is consistent with a suspicion of pulmonary sequestration. Bronchoscopic examination revealed a normal endobronchial appearance. Bronchial lavage examination was negative for acid-fast bacilli. Her thoracic Magnetic Resonance (MR) angiography showed an arterial supply from descending thoracic aorta. Pulmonary functional tests were within normal limits. The patient was referred to surgery, and a left-sided thoracotomy was performed. The lesion was located within the pleural space between the diaphragm and the lower lobe. Four arteries arising from the descending aorta were identified. The anomalous pulmonary tissue was removed by mass excision. Pathologic examination of surgical material obtained diagnosis of extralobar pulmonary sequestration. The patient still remains in excellent condition after nearly two years from the operation. We described the case of a 36-year-old Turkish female with an extralobar pulmonary sequestration who suffered from chest and back pain for five years without any evidence of pulmonary infection. A chest X-ray showed an area of opacity behind the cardiac silhouette in the lower area of the left hemithorax. A CT scan of the thorax with intravenous contrast showed a 9 x 7 cm in size ovoid mass with necrosis in the...

No abstract

Objective: Right ventricular (RV) dysfunction in acute pulmonary embolism (APE) has been associated with increased mortality and morbidity. The aim of the present study was to assess the timing and magnitude of regional RV functions using speckle-tracking echocardiography (STE) and their relationship to early hospital mortality in patients with APE. Methods: One hundred forty-two patients were prospectively studied at the onset of an acute episode and after a median follow-up period of 30 days. Their clinical and laboratory characteristics were recorded. For all patients, conventional two-dimensional echocardiography and STE were performed within 24 h after the diagnosis of APE. Results: Twenty-eight (19.7%) patients died during the hospitalization follow-up. Patients who died during hospitalization were older and had higher high sensitivity cardiac troponin T levels, and a higher percentage of patients had simplified Pulmonary Embolism Severity Indexes. In STE analyses, they had lower RV free wall peak longitudinal systolic strain (PLSS) and higher RV peak systolic strain dispersion indexes. The time to PLSS difference between RV free wall and LV lateral was longer in patients who died during hospitalization than in those who survived, and this was an independent predictor of early hospital mortality with 85.7% sensitivity and 75.0% specificity in patients with APE. Conclusion: APE was associated with RV electromechanical delay and dispersion. Electromechanical delay index might be useful to predict early hospital mortality in patients with APE.

No abstract