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    Acebutolol-induced massive pleural thickening
    (2010) Kiyan E.; Tulek B.; Kiliçaslan Z.; Yilmazbayhan D.
    Many patients take beta-blockers to control hypertension or angina, and such medication is often continued for years. Drug-induced pulmonary diseases due to beta-blockers have been published previously as pulmonary parenchymal infiltration and pleurisy, but bilateral multifocal and extensive pleural thickening alone has not been mentioned previously. In our case, Naranjo Adverse Drug Reaction probability scale score indicated that massive pleural thickening was a possible adverse reaction associated with long term use of acebutolol.
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    Anti-inflammatory and anti-fibrotic effects of sirolimus on bleomycininduced pulmonary fibrosis in rats
    (2011) Tulek B.; Kiyan E.; Toy H.; Kiyici A.; Narin C.; Suerdem M.
    Purpose: Pulmonary fibrosis is a devastating disease with a poor prognosis. Although the diagnosis and pathophysiology of this disease have been better characterized over the past few years, there is no effective therapy for the disease. The aim of this study was to evaluate the anti-inflammatory and anti-fibrotic effects of sirolimus (SRL), which is a potential anti-fibrotic agent, by using bleomycin (BLM)-induced pulmonary fibrosis model in rats. Methods: A single intra-tracheal injection of BLM (2.5 U/kg) was administered and sirolimus (2.5 mg/kg/day) was given orally, beginning either one day before (early SRL) or nine days after (late SRL) the BLM administration. The effect of SRL on fibrosis was studied by analysis of cytokine levels in BAL fluid, measurement of lung tissue hydroxyproline (HPL) content and histopathological examination. Results: Both early and late SRL administrations caused a decrease in the levels of IL-13, PDGF-A and TGF-?1 (p=0.001) and an increase in IFN-? levels (p=0.001) in BAL fluid. Early and late SRL also caused a decrease in HPL content (p=0.001). Early sirolimus caused a significant decrease in fibrosis score (p=0.001), while late SRL did not. Conclusion: Sirolimus was effective in BLM-induced pulmonary fibrosis model, especially in the early phases of the disease. © 2011 CIM.
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    Assessment of ocular neurotoxicity in patients treated with systemic cancer chemotherapeutics
    (2014) Bakbak B.; Gedik S.; Koktekir B.E.; Yavuzer K.; Tulek B.; Kanat F.; Pancar E.
    Purpose: Cisplatin and Paclitaxel are two chemotherapeutic agents known to produce neurotoxicity when used for cumulative dose regimens. In this study we aim to assess their toxicity in the optic nerve, and to evaluate the retinal nerve fibre layer (RNFL) thickness and visual field changes in lung cancer patients treated with Cisplatin and Paclitaxel. Methods: Fifteen patients who were treated intravenously with 75mg/m2 cisplatin and 175mg/m 2 paclitaxel every 3 weeks, up to a maximum of six courses, were enrolled in this prospective clinical trial. All patients underwent complete ophthalmological assessments before their treatments began, as well as three months after the completion of their treatments. The RNFL thickness measurements were performed using optical coherence tomography (OCT). Functional testing included the use of frequency-doubling technology (FDT) perimetry and the Humphrey visual field analyser (HFA). The main outcome measurements included the average RNFL thicknesses and visual field indices (mean deviation [MD] and pattern standard deviation [PSD]). Results: The median age of the 15 patients (nine male and six female) was 63.49 years old (range: 53-77). The average RNFL thickness measurement during the baseline examination was 103.73?m (range: 97-111). Three months after the cessation of treatment the RNFL thickness declined to 97.4?m (range: 91-102). Statistical analysis showed a significant thinning between the two measurements (p=0.032). The MD and PSD values recorded by the HFA demonstrated no statistically significant changes 3 months after the cessation of treatment (p>0.207 and p>0.186, respectively). There were statistically significant decreases in both the MD (0.48 to-1.13dB) and PSD (2.13 to 0.65dB) indices measured by the FDT perimetry (p=0.041 and p=0.025, respectively). Conclusions: In our study, the systemic administration of Cisplatin and Paclitaxel affected the peripapillary RNFL thicknesses and visual field indices as revealed by FDT perimetry. OCT and FDT perimetry may be adjunctive tools for the screening of ocular toxicity in patients treated with these agents. © 2014 Informa Healthcare USA, Inc.