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Öğe Diagnostic Value of Galectin-3 for Identifying Acute Pulmonary Embolism in the Emergency Department(Elsevier Inc., 2022) Kara, Hasan; Bayir, Aysegul; Altug, Ertugrul; Degirmenci, Selim; Unlu, Ali; Ak, Ahmet; Kayis, Seyit AliBackground: Pulmonary embolism (PE) is a common disease associated with high mortality and morbidity. Diagnosing PE is challenging due to diverse clinical presentations and the lack of specific biomarkers. Objective: We hypothesized that plasma galectin-3 (Gal-3) levels might reflect the severity of acute PE and be useful for diagnostic assessment. Methods: In this prospective study, 150 patients (100 patients with PE and 50 control patients) were included. Patients were stratified into high-risk, medium-risk, and low-risk groups according to the Wells and revised Geneva scoring systems, and Gal-3 levels were compared among the groups. PE was diagnosed by means of computed tomography pulmonary angiography. Results: In this study, of the 100 PE patients included in the study, 69 patients recovered and were discharged and 31 patients died. Median Gal-3 value in the PE group was 27.0 ng/mL (range 11.5–35.0 ng/mL), whereas the median Gal-3 value in the control group was significantly lower at 8.8 ng/mL (range 1.0–21.0 ng/mL) (p < 0.001). When the Gal-3 values of the PE group and the control group were evaluated with the receiver operator characteristic curve, the area under the curve was calculated as 0.99 (95% confidence interval 0.979–1). At a Gal-3 cutoff value of 13.55 ng/mL, which was determined to be the most appropriate value for PE diagnosis, the sensitivity was 98% and the specificity was 92%. Conclusions: A biomarker that rapidly and accurately diagnoses acute PE in the emergency department can be an extremely useful tool. We concluded that plasma Gal-3 levels can be regarded as a promising marker of acute PE. © 2022Öğe Diagnostic value of mid-regional pro-atrial natriuretic peptide (MR-proANP) level in patients with acute pulmonary embolism(Bayrakol Medical Publisher, 2023) Altuğ, Ertuğrul; Kara, Hasan; Bayır, Ayşegül; Ak, Ahmet; Kayış, Seyit Ali; Ünlü, AliAim: Right ventricular failure can develop in patients with pulmonary embolism (PE) and is associated with increased mortality. Mid-regional pro-atrial natriuretic peptide (MR-proANP), a natriuretic peptide, is secreted due to the increased atrial wall tension caused by right heart failure. In this study, we aimed to investigate the diagnostic value of MR-proANP in patients who presented to the emergency department with a pre-diagnosis of pulmonary embolism.Material and Methods: Among patients with a preliminary diagnosis of PE, 100 patients who were confirmed to have PE by computed tomography pulmonary angiography (CTPA) were determined as the case group. As a control group, 50 patients were randomly identified, in whom the diagnosis of PE was excluded. Echocardiography was performed in all patients in the case group immediately after the diagnosis was confirmed, and the presence of right ventricular dysfunction was investigated. This study was designed as a prospective observational study.Results: The median value of MR-proANP (645.8 (66.37-3313.08) pmol/L) in the case group was found to be significantly higher than median value of MR-proANP (442.9 (226.73-774.78) pmol/L) in the control group (p:0.003). MR-proANP was found to be significantly higher in the differential diagnosis of PE.Discussion: In addition to clinical signs and symptoms, MR-proANP levels seem to be a useful variable that may improve diagnostic accuracy in patients with suspected pulmonary embolism in the emergency department.Öğe Ön çapraz bağ tamiri sonrasında menüsküs iyileşmesinin histolojik ve radyolojik takibi: Deneysel çalışma(2000) Demirkaya, Mehmet; Kara, Hasan; Yıldırım, Yakup; Orhan, Zafer; Şirvancı, MustafaAmaç: Ön çapraz bağ (ÖÇB) rekonstrüskiyonu yapılan dizlerde menüsküs yırtıklarının iyileşmesi (tamir yapılan ve yapılmayan) histolojik ve radyolojik olarak incelendi. Çalışma planı: Sekiz koyun rastgele olarak dört gruba ayrılıp, ÖÇB hepsinde tamamen çıkartıldı ve medial menüsküs 1/3 periferal bölümde longitidunal yırtık oluşturuldu. Her iki dizde ÖÇB rekonstrüksiyonu yapılıp sağ dizlerde menüsküs yırtıkları sütüre edildi. Tamir sonrası 1, 2, 3 ve 6. haftalarda ikili gruplar halinde kesilen koyunların dizleri manyetik rezonans görüntüleme ile incelendi; ardından menüsküs iyileşmesi histolojik olarak değerlendirildi. Sonuçlar: Manyetik rezonans görüntülemede birinci ve ikinci haftalarda hem kontrol hem de çalışma grubundaki menüsküslerde yırtık bölgesine kontrast madde geçişi gözlenirken, üçüncü ve altıncı haftalarda her iki grupta da geçiş gözlenmedi. Histolojik incelemelerde Henning kriterlerine göre bazı menüsküslerde iyileşmeme (1, 2 ve 3. haftalarda %50’den fazla rezidüel yarık) ve parsiyel iyileşme (6. hafta %10-50 arası rezidüel yarık) görülürken tam iyileşme (%10’dan az rezidüel yarık) hiçbir örnekte görülmedi. Çıkarımlar: Rekonstrüksiyon yapılan dizlerde, tamir edilen ve edilmeyen gruplarda menüsküs iyileşmesinin normal seyrinde devam etmesi ve ÖÇB’nin oluşturduğu stabilite nedeniyle, menüsküslerde liflenmeye ve kompleks yırtıklara rastlanmamış olması, ÖÇB rekonstrüksiyonlu dizlerde menüsküs tamirinin gereksiz olduğunu göstermektedir.Öğe Penetrating type intraosseous ganglion cyst of the lunate bone (vol 54, pg 247, 2005)(Univ West Indies Faculty Medical Sciences, 2005) Tüzüner, Tolga; Subaşı, Mehmet; Alper, Murat; Kara, Hasan; Orhan, ZaferIntraosseous ganglion cysts of the carpal bones located in the lunate are one of the rarely seen pathologic conditions. Here we present a case of the penetrating type of intraosseous ganglion Cyst located in the lunate as an uncommon cause of wrist pain. The patient was successfully treated by surgical intervention. Intraosseous ganglion cyst should be considered in the differential diagnosis of chronic dull wrist pain.
