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    Evaluation of pulmonary artery stiffness and right ventricle functions in polycythemia vera patients by transthoracic echocardiography
    (Wiley, 2023) Karaca, Yuecel; Hidayet, Siho; Bayramoglu, Adil; Yildirim, Erkan; Berber, Ilhami; Guven, Fatih; Yigit, Yakup
    IntroductionPolycythemia vera (PV) is known to be a subgroup of chronic myeloproliferative neoplasms and is recognized as a cause of pulmonary hypertension (PH). Pulmonary artery stiffness (PAS) is a relatively new noninvasive echocardiographic index developed to evaluate the structural features and functions of the pulmonary vascular bed. In this study, we aimed to evaluate right ventricular (RV) functions and PAS in PV patients and healthy controls. MethodsA group of 65 consecutive PV patients and 40 healthy controls were included in the study. RV global longitudinal strain (RVGLS) and RV free wall longitudinal strain were (RVFwLS) evaluated using two-dimensional (2D) strain echocardiography. RV volume, systolic and diastolic functions were evaluated with three-dimensional (3D) echocardiography. PAS was calculated using the maximum frequency shift (MFS) and acceleration time of the pulmonary artery flow trace. ResultsPAS values were significantly higher in the PV group than in the control group (25.2 +/- 5.2 vs. 18.2 +/- 4.2, p < .001). We found that tricuspid annular plane systolic excursion (TAPSE) (p < .001), RV fractional area change (p < .001) and RV ejection fraction (p < .001) measurements evaluated by 3D echocardiography were significantly lower in the PV group. ConclusionIn our study, PAS values were higher in PV patients than in the healthy control group. Patients with PV may have subclinical RV dysfunction, and PAS value can be used in the early diagnosis of PH and RV dysfunction in this patient group.
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    A rare cause of dyspnea: Isolated congenitally corrected transposition of the great arteries
    (2021) Ulutas, Zeynep; Yildirim, Erkan; Abdelrahman, Hasan; Hidayet, Siho
    Corrected transposition of the great arteries is a rare pathology with an incidence of 1% among the congenital heart diseases. It is thought to have multifactorial inheritance. It is mostly seen in men. If there is no concomitant pathology, the blood flow is physiological and does not show symptoms until advanced ages. Life expectancy is close to normal in those with isolated pathology. Risk factors determining mortality include progressive right ventricular dysfunction, AV block, and severe tricuspid insufficiency. In this case, we present a CCTGA patient with dyspnea symptoms without any additional pathology.
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    Spinal Epidural Abscess of Brucella Mimicking Lumbar Disc Herniation: Case Report and Review of the Literature
    (Journal Neurological Sciences, 2011) Yakupogullari, Yusuf; Koroglu, Mehmet; Yildirim, Erkan; Karayol, Ali
    A 37 years old woman admitted to neurosurgery clinic, with progressive nerve root compression symptoms for three months. She had no benefit from some medications and physical therapy courses which were performed due to diagnosis of protruded lumbar disc herniation. At the initial evaluation, she had difficulty on standing up and walking. A cyst 2x3 cm in size was removed from L5-S1 level with surgical operation. Brucella was isolated from the pus culture of the cyst content. The patient was completely recovered with postoperative doxycycline and co-trimoxazole therapy. Review of the published reports have suggested that spinal epidural abscess of brucella has predominantly seen in lumbar region and particularly among the patients over 30 years old. Although alone antimicrobial treatment has been increasingly recommended by some authors, surgical operation plus postoperative antibiotic treatment seems to be very effective for short term recovery. Brucella seroagglutination tests may be very helpful in differential diagnosis.