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    Hemostatic changes in active pulmonary tuberculosis
    (Ingenta Connect, 2002) Kunter, E.; Sezer, M.; Solmazgül, E.; Cerrahoğlu, K.; Bozkanat, E.; Öztürk, A.; İlvan, A.
    Objective: Severe pulmonary tuberculosis (PTB) is sometimes complicated by deep vein thrombosis (DVT). We have searched for possible hemostatic disturbances that are predisposing factors for venous thrombosis in patients with PTB. Design: Coagulation and platelet function tests were studied in 45 patients with active PTB and 20 healthy control volunteers before therapy. Findings were compared with results at 30 days. Results: Analysis in patients with active PTB showed anemia, leucocytosis, thrombocytosis, elevation in plasma fibrinogen, factor VIII, plasminogen activator inhibitor 1 (PAI-1) with depressed antithrombin III (AT III) and protein C (PC) levels. On the 30th day of treatment, anemia, leucocytosis and thrombocytosis were improved. Fibrinogen and factor VIII levels had decreased to normal levels, PC and AT III levels had increased to normal levels, and there was no difference in PAI-1 levels. We found no activated protein C resistance. Platelet aggregation studies demonstrated increased platelet activation. However, DVT was not detected in patients during the follow-up period. Conclusion: Decreased AT III, PC and elevated plasma fibrinogen levels and increased platelet aggregation appear to induce a hypercoagulable state seen in PTB and improve with treatment.
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    Oral etoposide-induced leucocytoclastic vasculitis in a patient with lung carcinoma
    (Wiley Online Library, 2007) Karagöz, B.; Bilgi, O.; Doğan, B.; Kandemir, E. G.; Kunter, E.
    Oral etoposide-induced leucocytoclastic vasculitis in a patient with lung carcinoma
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    Prevalance and prognostic value of c-erbB2 expression in non-small cell lung cancer (NSCLC)
    (AEPress, 2003) Kunter, E.; Çermik, H.; Işıtmangil, T.; Kandemir, E. G.; Yaylacı, Mustafa; Öztürk, A.
    The c-erbB2 oncoprotein is highly expressed in approximately one third of non-small cell lung cancer (NSCLC) patients. We determined the status of c-erbB2 expression in our patients with NSCLC and investigated its correlation with disease stage, histological type and response to treatment. Eighty-four patients were examined for the expression of c-erbB2 by immunohistochemistry using a polyclonal antibody. The scoring criteria of Clinical Trial Assay (CTA) were used to evaluate staining (0 to +3). c-erbB2 overexpression was determined in 35% of the cases. Tumors from higher stage disease (stage IIIb-IV) were more often c-erbB2 positive in adenocarcinoma (ADC) (p=0.04). In addition, there was an association between c-erbB2 score and disease stage in ADC patients (p=0.03). Our study did not demonstrate an association of c-erbB2 overexpression with response to chemotherapy. We conclude that c-erbB2 overexpression may be a prognostic marker for evaluating tumor progression in NSCLC patients but further studies must be performed with larger patient populations.
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    The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients
    (Elsevier, 2003) Kunter, E.; Cerrahoğlu, K.; İlvan, A.; Işıtmangil, T.; Okutan, O.; Kartaloğlu, Z.; Çavuşlu, S.
    Objectives To determine if detection of IgM and IgG antibodies against mycobacterial antigen A60, together with the Mantoux tuberculin skin test (TST), could be used in the diagnosis of tuberculous pleurisy (TP) in BCG-vaccinated cases. Methods We investigated 125 BCG-vaccinated patients with pleural effusion. Of these, 88 had TP and 37 had non-tuberculous pleurisy (NTP). TST and anti-A60 IgM and IgG measurements by ELISA were performed in the sera and pleural effusions of both groups. Results Cut-off values, in optical density, for serum anti-A60 IgM, pleural fluid anti-A60 IgM, serum anti-A60 IgG and pleural fluid anti-A60 IgG were defined as 0.624, 0.614, 0.464, and 0.613, respectively. TP patients had higher IgG and IgM levels in the serum (P < 0.001 and P < 0.05, respectively) and pleural effusion (P < 0.001 and P < 0.001, respectively). Regardless of the diagnosis, IgG and IgM levels were higher in the sera (P < 0.001 and P < 0.05, respectively) and pleural effusions (P < 0.001 and P < 0.001, respectively) of TST-positive cases, and serum and pleural fluid IgM levels were higher (P < 0.001 and P < 0.001, respectively) in the TST-positive TP cases. Sensitivity and specificity of TST were 65% and 68%, respectively. As a single parameter, pleural fluid anti-A60 IgM had the highest sensitivity (77%) and specificity (94%) in patients with negative TST. Conclusion We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.
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    The value of pleural fluid anti-A60 IgM in BCG-vaccinated tuberculous pleurisy patients.
    (Elsevier, 2003) Kunter, E.; Cerrahoğlu, K.; İlvan, A.; Işıtmangil, T.; Okutan, O.; Kartaloğlu, Z.; Çavuşlu, Ş.
    Objectives: To determine if detection of IgM and IgG antibodies against mycobacterial antigen A60, together with the Mantoux tuberculin skin test (TST), could be used in the diagnosis of tuberculous pleurisy (TP) in BCG-vaccinated cases. Methods: We investigated 125 BCG-vaccinated patients with pleural effusion. Of these, 88 had TP and 37 had non-tuberculous pleurisy (NTP). TST and anti-A60 IgM and IgG measurements by ELISA were performed in the sera and pleural effusions of both groups. Results: Cut-off values, in optical density, for serum anti-A60 IgM, pleural fluid anti-A60 IgM, serum anti-A60 IgG and pleural fluid anti-A60 IgG were defined as 0.624, 0.614, 0.464, and 0.613, respectively. TP patients had higher IgG and IgM levels in the serum (P < 0.001 and P < 0.05, respectively) and pleural effusion (P < 0.001 and P < 0.001, respectively). Regardless of the diagnosis, IgG and IgM levels were higher in the sera (P < 0.001 and P < 0.05, respectively) and pleural effusions (P < 0.001 and P < 0.001, respectively) of TST-positive cases, and serum and pleural fluid IgM levels were higher (P < 0.001 and P < 0.001, respectively) in the TST-positive TP cases. Sensitivity and specificity of TST were 65% and 68%, respectively. As a single parameter, pleural fluid anti-A60 IgM had the highest sensitivity (77%) and specificity (94%) in patients with negative TST. Conclusion: We suggest that in populations where tuberculosis prevalence is high and BCG vaccination is common, pleural fluid anti-A60 IgM can facilitate the diagnosis of TP.