Background and aimsAnxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD). The degree of lung function may not explain anxiety and depression. The aim of our study was to assess the psychological aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capacity), and to evaluate the association between atypical cytologic findings of sputum, bronchoalveolar lavage (BAL) and the pyschological components of the disease.MethodsCOPD was classsified according to the GOLD stages based on forced expiratory volume in 1 second (FEV1) in 60 stable patients. The BODE index was calculated for grading COPD. The Hospital anxiety and depression (HAD) scale was used to appraise the anxiety and depression symptoms. Cytologic examination of sputum and BAL samples were performed in each patient. The cytologic findings were classified as normal, mild, moderate or severe atypia.ResultsThe overall prevalance of anxiety and depression symptoms was 41.7% and 46.7% respectively. The prevalance of these symptoms increased with increasing BODE stages and correlated well with the severity of atypical BAL cytology results (p < 0.001). Dyspnea and reduced exercise capacity were the predominant mechanisms leading to anxiety and depression symptoms associated with COPD.ConclusionsWe conclude that the BODE index is superior to GOLD stratification for explaining anxiety and depression symptoms in COPD. BAL cytologic findings, which reflect the distal parenchymal lung structure, correlated significantly with the presence of the anxiety and depression symptoms.
Background and aims: Anxiety and depression are common in patients with chronic obstructive pulmonary disease (COPD). The degree of lung function may not explain anxiety and depression. The aim of our study was to assess the psycholog- ical aspects of COPD, to test the BODE index (a composite score of body mass, obstruction, dyspnea and exercise capac- ity), and to evaluate the association between atypical cyto- logic findings of sputum, bronchoalveolar lavage (BAL) and the pyschological components of the disease. Methods: COPD was classsified according to the GOLD stages based on forced expiratory volume in 1 second (FEV1) in 60 stable patients. The BODE index was calculated for grading COPD. The Hospital anxiety and depression (HAD) scale was used to appraise the anxiety and depression symptoms. Cytologic examination of sputum and BAL samples were per- formed in each patient. The cytologic findings were classified as normal, mild, moderate or severe atypia. Results: The overall prevalance of anxiety and depression symptoms was 41.7% and 46.7% respectively. The prevalance of these symptoms increased with increasing BODE stages and correlated well with the severity of atypical BAL cytology results (p < 0.001). Dyspnea and reduced exercise capacity were the predominant mechanisms leading to anxiety and depression symptoms associated with COPD. Conclusions: We conclude that the BODE index is superior to GOLD stratification for explaining anxiety and depression symptoms in COPD. BAL cytologic findings, which reflect the distal parenchymal lung structure, correlated significantly with the presence of the anxiety and depression symptoms.
OBJECTIVES:Multiple genetic changes are observed in malignant tumors but are rare or absent in benign conditions. Aneuploidy is the most common feature of solid tumors including lung cancer and diagnosis of malignant tumors is possible through detection of aneuploidy. The aim of this study was to investigate chromosomal abnormalities in cells from non-small cell lung cancer patients obtained bronchoscopically and to evaluate the suitability of fluorescence in situ hybridization (FISH). MATERIAL AND METHODS:Bronchial lavage samples of 17 non-small cell lung cancer (NSCLC) patients were evaluated with fourcolor FISH using deoxyribonucleic acid (DNA) probes specific for the centromere regions of chromosomes 3, 7 and 8. tested specimens were first hybridized with probes, then visualized under fluorescence microscobeand captured with device's camera. RESULTS:High number of aneuploidic cells were detected in all the samples. Increased or decreased abnormal copies or chromosomes 3, 7 and 8 were obserced in all the 17 patients. Aneuploidy of chromosome 3 (21.35%) was higher than those of chromosome 7 (9.06%) and chromosome 8 (15.47%). Moreover, our results were significant for monosomy and trisomy of chromosome 3, trisomy of chromosome 7, nullisomy, monosomy and trisomy of, chromosome 8 (p< 0.05). CONCLUSION:It has been observed that FISH is a useful technique for detection of aneuploidy in bronchial lavage samples obtained by bronchoscopy. Interphase cells were evaluated without cell culturing with this method and high number of tumor cells were enumerated rapidly. Our study has demonstrated that, FISH technique may be used successfully in detection of chromosome number abnormalities in NSCLC patients and may facilitate evaluation of genetic abnormalities.
The sensitivity and specificity of exfoliative cell cytology for the diagnosis of exudative pleural effusions varies widely according to the etiologic causes. The aim of this study is to assess the diagnostic value of exfoliative cell cytology for the identification of exudative pleural effusions. This is a retrospective study of the patients with an exudative pleural effusion admitted at our clinic in the last twenty years. We have conducted the clinical, the cytological findings, and the diagnostic results of six hundred patients from hospital records. Male to female ratio was 2.2:1 with a mean age of 42.8 years (range 18-78 years) among the patients. Samples were processed and evaluated according to the standard methods. Cytology results were reviewed and the patients were stratified according to the final diagnosis of their disease. Of the six hundred exudative effusions, 240 were malignant on exfoliative cytology pleural fluid alone. Adenocarcinoma was the most common type of malignancy. Tuberculosis was the second most frequent etiology for the exudative effusions followed by infection and collagen vascular diseases. Diagnostic accuracy of cytology showed a good correlation with the final diagnosis with an overall 70.1% sensitivity, 62.5% specificity, and a 95.9% positive predictive value for all exudative pleural effusions. Cytologic examination of the pleural fluid is a simple non-invasive procedure as the initial step for the diagnostic work up of patients with a pleural effusion. Exfoliative cytology provides high a final diagnostic yield for the identification of an exudative pleural effusion etiology. Furthermore, cytologic analysis leads the clinician into the correct diagnostic pathway as the most informative laboratory tool even when it was not diagnostic by itself for equivocal cases.
OBJECTIVES:Multiple genetic changes are observed in malignant tumors but are rare or absent in benign conditions. Aneuploidy is the most common feature of solid tumors including lung cancer and diagnosis of malignant tumors is possible through detection of aneuploidy. The aim of this study was to investigate chromosomal abnormalities in cells from non-small cell lung cancer patients obtained bronchoscopically and to evaluate the suitability of fluorescence in situ hybridization (FISH). MATERIAL AND METHODS:Bronchial lavage samples of 17 non-small cell lung cancer (NSCLC) patients were evaluated with fourcolor FISH using deoxyribonucleic acid (DNA) probes specific for the centromere regions of chromosomes 3, 7 and 8. tested specimens were first hybridized with probes, then visualized under fluorescence microscobeand captured with device's camera. RESULTS:High number of aneuploidic cells were detected in all the samples. Increased or decreased abnormal copies or chromosomes 3, 7 and 8 were obserced in all the 17 patients. Aneuploidy of chromosome 3 (21.35%) was higher than those of chromosome 7 (9.06%) and chromosome 8 (15.47%). Moreover, our results were significant for monosomy and trisomy of chromosome 3, trisomy of chromosome 7, nullisomy, monosomy and trisomy of, chromosome 8 (p< 0.05). CONCLUSION:It has been observed that FISH is a useful technique for detection of aneuploidy in bronchial lavage samples obtained by bronchoscopy. Interphase cells were evaluated without cell culturing with this method and high number of tumor cells were enumerated rapidly. Our study has demonstrated that, FISH technique may be used successfully in detection of chromosome number abnormalities in NSCLC patients and may facilitate evaluation of genetic abnormalities.
Ö ÖZ ZE ET T AAm ma aç ç: : Sarkoidoz patogenezi iyi bilinmeyen sistemik bir hastalıktır. Olguların %50'sinde akciğer tutulumu görülür. Pulmoner sarkoidozla birlikte görülen kontrolsüz T hücresi proliferasyonu ve zararlı kimyasal mediyatörlerin salınması gibi patolojik olaylar immünolojik mekanizmalar ile açıklanabilir. Pulmoner sarkoidozda Th1 sitokinlerinin ve makrofaj aktivasyonu ile ilgili sitokinlerin sunumunun tercih edildiğini gösteren çalış-malar mevcut olmakla birlikte, sitokin sunumu konusunda yeterince çalışılmamıştır. Bu çalışmada, sarkoidozlu hastaların akciğerlerinde görülen yangısal olayların başlaması ve devamından sorumlu olan hücre tiplerini ve bu yangısal reaksiyonları yönlendirmede önemli olabilecek sitokinlerin sunumunu araştırmayı amaçladık. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Çalışmada 7 sarkoidozlu hasta ile 7 sağlıklı kontrolden alınan bronkoalveolar lavaj (BAL) sıvısından sitosantrüfüjde hazırlanan preparatlar kullanıldı. Tüm örneklere CD4 ve CD8 monoklonal antikorları ile immün boyama yapılarak T hücresi alt tiplerinin dağılımı araştırıldı. Ayrıca T yardımcı-1(Th1) tipi sitokinlerden olan interferon gama (IFNγ) ve bir makrofaj belirteci olan CD68 ekspresyonu da immünohistokimyasal olarak incelendi. B Bu ul lg gu ul la ar r: : Sarkoidozlu hastaların BAL sıvılarından hazırlanan sitosantrifüj preparatlarında lenfosit sayısında sağlıklı kontrol grubuna kıyasla anlamlı (p=0,002) bir artış saptandı. T lenfositi alt gruplarının incelenmesi sonucunda CD4(+) yardımcı T hücrelerinin (Th) (%21,59±0,87) CD8(+) baskılayıcı T hücrelerine (Ts) (%10,40±0,59) kıyasla çoğunlukta olduğu gözlendi. Th/Ts (CD4+/CD8+) oranı sarkoidoz grubunda 2/1 olarak saptandı. Sarkoidozlu hastaların BAL preparatlarında IFNγ sunumu yapan T hücrelerine rastlandı. CD68 sunumu, sarkoidozlu gruptaki makrofajların yanı sıra, bazı dev hücreler, lenfositler ve polimorf nüveli lökositlerde de görüldü. S So on nu uç ç: : Bulgularımız, yardımcı T lenfositlerdeki artışın, sarkoidoz patogenezine katılan önemli bir faktör olduğunu ve artmış lenfositlerin Th1 tipi sitokinlerin sunumunu tercih ettiğini göstermektedir.A An na ah ht ta ar r K Ke el li im me el le er r: : Sarkoidoz; CD4-pozitif T-lenfositler; CD8-pozitif T-lenfositler; makrofajlar, alveolar; CD68 antigeni, insan; IFN-gama(95-132) peptit A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : Sarcoidosis is a systemic disease with an unclear pathogenesis. Pulmonary involvement develops in 50% of cases. Pathologic events like uncontrolled T cell proliferation and release of harmful mediators seen in pulmonary sarcoidosis may be explained with immunologic mechanisms. Pulmonary sarcoidosis has been shown to be related to an increased production of Th1 cytokines and an activation of macrophages. However, cytokine expression in sarcoidosis has not been systematically studied yet. In this study, we aimed to investigate the cell types responsible for initiation and maintanence of inflammatory reactions in the lungs of sarcoidosis patients and expression of cytokin...
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