Browsing by Author "Koksal, Deniz"

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    Association of Class II Human Leukocyte Antigen (Hla) Alleles with Pulmonary Sarcoidosis
    (2018) Esendagli, Dorina; Ozmen, Fusun; Koksal, Deniz; Onder, Sevgen; Emri, Salih; https://orcid.org/0000-0002-6619-2952; https://orcid.org/0000-0001-8374-3691; 32476894; ABF-9398-2020; ABE-1458-2020
    Background and objectives: Sarcoidosis is a systemic inflammatory disease of unknown etiology that involves any part of the body, mainly the lungs and thoracic lymph nodes. The clinical presentation is heterogeneous based on the degree and extent of organ involvement. The existence of variable clinical presentations and treatment responses suggest an important role of genetic predisposition. In genetic studies, sarcoidosis was found to be associated with several genes, but the strongest link was with HLA region. The aim of this study was to investigate the association of HLA class II alleles with the extent and course of disease in Turkish patients with sarcoidosis. Methods: The study included 103 patients with sarcoidosis and 100 unrelated healthy controls. HLA-DRB1 and HLA-DQB1 typing was performed by using Polymerase Chain Reaction-Sequence Specific Priming ( PCR-SSP) method at low resolution level. Results: HLA-DRB1* and -DQB1* analysis revealed that while the frequency of HLA-DRB1* 01 was significantly higher in the control group, HLA-DRB1* 13 and -DQB1* 06 alleles were more frequent in the sarcoidosis patients. When the patients were grouped based on clinical outcome as remitters and non-remitters, HLA-DRB1* 10 allele was only detected in the remitters, whereas the frequency of HLA-DQB1* 06 allele was significantly higher in non-remitters. Conclusions: This study supported the association of HLA alleles with sarcoidosis. In a considerably high number of patients with Turkish origin, the frequency of HLA-DRB1* 13, -DRB1* 10 and HLA-DQB1* 06 alleles was significantly associated with increased risk and clinical outcome.
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    Evaluation of Exudative Pleural Effusions: A Multicenter, Prospective, Observational Study
    (2022) Ak, Guntulu; Metintas, Selma; Taskin, Ayse Naz; Sener, Melahat Uzel; Soyler, Yasemin; Yilmaz, Meltem; Turna, Akif; Kabalak, Pinar Akin; Bilaceroglu, Semra; Koksal, Deniz; Demirci, Nilgun Yilmaz; Sogukpinar, Ozlem; Boga, Sibel; Ercelik, Merve; Karadeniz, Gulistan; Polat, Gulru; Guldaval, Filiz; Akturk, Ulku Aka; Yilmaz, Senay; Ogan, Nalan; Yilmaz, Saliha; Esendagli, Dorina; Caglayan, Benan; Zeybek, Arife; Kocak, Nagihan Durmus; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Mutlu, Pinar; Baytemir, Cansel Atinkaya; Sarbay, Ismail; Yilmaz, Ulku; Metintas, Muzaffer; 36173482
    Purpose The aim of this study is to determine the diagnostic performances of pleural procedures in undiagnosed exudative pleural effusions and to evaluate factors suggestive of benign or malignant pleural effusions in tertiary care centers. Methods This was a multicenter prospective observational study conducted between January 1 and December 31, 2018. A total of 777 patients with undiagnosed exudative pleural effusion after the initial work-up were evaluated. The results of diagnostic procedures and the patients' diagnoses were prospectively recorded. Sensitivity, specificity, and accuracy estimates with 95% confidence intervals were used to examine the performance of pleural procedures to detect malignancy. Results The mean age +/- SD of the 777 patients was 62.0 +/- 16.0 years, and 68.3% of them were male. The most common cause was malignancy (38.3%). Lung cancer was the leading cause of malignant pleural effusions (20.2%). The diagnostic sensitivity and accuracy of cytology were 59.5% and 84.3%, respectively. The diagnostic sensitivity of image-guided pleural biopsy was 86.4%. The addition of image-guided pleural biopsy to cytology increased diagnostic sensitivity to more than 90%. Thoracoscopic biopsy provided the highest diagnostic sensitivity (94.3%). The highest diagnostic sensitivity of cytology was determined in metastatic pleural effusion from breast cancer (86.7%). Conclusion The diagnostic performance increases considerably when cytology is combined with image-guided pleural biopsy in malignant pleural effusions. However, to avoid unnecessary interventions and complications, the development of criteria to distinguish patients with benign pleural effusions is as important as the identification of patients with malignant pleural effusions.