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Öğe Acil serviste dinamik bilgisayarlı tomografi ile pulmoner emboli tanısı konulan hastaların manyetik rezonans görüntüleme bulgularının değerlendirilmesi(İnönü Üniversitesi, 2012) Yumrutepe, SevgiPE hayatı tehdit eden acil servislerde hekimlerin sık karşılaştığı bir hastalıktır. Erken tanı tedavisi kadar önemlidir. Toraks BT, PE tanısında en sık kullanılan görüntüleme yöntemidir. Gebelerde, kontrast alerjisi ya da böbrek yetmezliği olan hastalarda toraks BT kontrendikedir. MR tetkiki son yıllarda kullanımı artan radyasyon içermemesi nedeniyle önemli bir görüntüleme yöntemidir. Bu çalışmanın amacı; PE düşünülen ancak böbrek yetmezliği, kontrast madde alerjisi, gebeliği olan hastalar ile görüntülemenin hızlı yapılması gereken hastalarda, toraks difüzyon MR görüntüleme tekniğinin kullanabilirliğini araştırmaktır. Gereç ve Yöntem: Bu prospektif çalışma 5 Aralık 2010 ? 31 Kasım 2011 tarihleri arasında hastanemiz Acil Servisine başvuran dinamik kontraslı BT ile PE tanısı konulmuş 29 hastayı kapsamaktadır. Dinamik kontrastlı toraks BT ile PE tanısı konulmuş bu hastalara toraks difüzyon MR görüntüleme yöntemi uygulandı. Bulgular: PE tanısı konulan 29 hastada, dispne ve göğüs ağrısının en sık başvuru nedeni olduğu tespit edildi. Ortalama ADC değeri tüm hastalar için 2.39x10-³±4.6 mm²/sn olarak bulundu. Enfarktların ortalama ADC değeri 1,98x10-³±4,5 mm²/sn olarak bulundu. Atelektazi alanları için ortalama ADC değeri 2,57x10-³±3,3 mm²/sn olarak bulundu. Atelektazi 20 (%59,1) hastada, enfarkt 9 (%30,9) hastada gözlendi. ADC değeri açısından atelektazi ve enfarkt arasındaki fark istatistiksel olarak anlamlı bulundu (p=0.0001). Sonuç: PE tanısının konulmasında ve PE'nin periferik lezyonlarının değerlendilmesinde toraks difüzyon MR tetkiki alternatif bir görüntüleme yöntemi olabilir. Özellikle gebelerde, kontrast madde alerjisi olanlarda, böbrek yetmezliği olan olgularda ve hızlı görüntülemenin gerektiği durumlarda, PE tanısında ve PE'nin periferik lezyonlarının değerlendilmesinde toraksın difüzyon ağırlıklı görüntüleme tetkiki yararlı sonuçlar verebilir. Difüzyon toraks MR görüntüleme tetkikinin PE tanısında kullanılabilmesi için daha erken dönemde uygulanmış daha çok vaka ile yapılacak çalışmalara ihtiyaç vardır.Öğe Assessment of change in neutrophil-lymphocyte ratio, platelet-lymphocyteratio in patients with acute and chronic urticaria(2018) Gür, Ali; Turgut, Kasım; Güven, Taner; Aytemur, Zeynep Ayfer; Oğuztürk, Hakan; Turtay, Muhammet Gökhan; Yumrutepe, SevgiAbstract: Aim: Urticaria is a skin disease characterized by erythematous, oedematous, itchy,and spontaneously disappearing urticaria lesions. One of the most common skin diseases, it is the most common reason underlying the presentations to emergency departments. Our objective is to investigate the role of systemic inflammation in urticaria pathogenesis by measuring the indicators of Neutrophil-Lymphocyte ratio (NLR) and Platelet-Lymphocyte ratio (PLR) in routine hemograms in patients with acute and chronic urticaria. Material and Methods: Of patients visiting the Dermatology Policlinic of İnönü University Medical School Hospital between July 2017 and February 2018, 69 patients diagnosed with acute urticaria and 188 patients diagnosed with chronic urticaria as well as 90 healthy people taken as controls with an age range of 18to 70 were included in our study. Blood values of patients were studied retrospectively. (For the study, a Research Ethics Approval was obtained from Malatya Research Ethics Board.) Results: No significant difference was detected among the study groups in terms of demographic properties. Whereas a significant difference was noted among the three groups with regard to NLR values, no statistically significant difference was detected among the groups with respect to PLR values. No statistically significant difference was observed between the group of patients with urticaria and the control group in terms of erythrocyte distribution(p: 0.01). On the other hand, when the patient group with chronic urticaria was divided into two subgroups as patients with a complaint duration of 90 days and less, and those with a complaint duration of more than 90 days and evaluated, no statistically significant difference was detected between these groups in terms of RDW, lymphocytes, neutrophils, platelets, NLR and PLR values Conclusion: In our study, we have determined that systemic inflammation has increased in the group of patients with urticaria as compared to the control group. What’s more interesting in this study is our conclusion that the pathways involved in continued inflammation do not change by time in chronic urticaria.Öğe Diffusion-weighted magnetic resonance imaging of thorax in diagnosis of pulmonary embolism(2018) Gür, Ali; Turgut, Kasım; Güven, Taner; Aytemur, Zeynep Ayfer; Oğuztürk, Hakan; Turtay, Muhammet Gökhan; Yumrutepe, SevgiAbstract: Pulmonary embolism (PE) has a high mortality rate and a considerable incidence in emergency care. Thorax computed tomography (CT) angiography is the primary diagnosis method for PE, but has many contraindications. In the present study, we aimed to determine the usability of Diffusion-weighted magnetic resonance imaging (DWMRI) in diagnosis of pulmonary embolism. Patients, diagnosed as pulmonary embolism previously by thorax CT angiography, were taken DWMRI. Demographic parameters, complaints, laboratory values and imaging findings were recorded on standart forms. Twenty nine patients, who were diagnosed as pulmonary emboli, were evaluated. Many of them were female(69%) and the mean of age was 61 years. Dyspnea and chest pain were the main complaints. Atelectasis(69,1%) and pulmonary infarct(30,9%) were determined lesions on CT and DWMRI. Region of interest (ROI) were determined by using MRI (T2) images. Three different ROI values were placed on areas and apparent diffusion coefficient (ADC) values were calculated for peripheric lung lesions. Significant difference was determine between mean ADC values of atelectasis and pulmonary infarct lesions (p<0.05). DWMRI can differentiate peripheric lesions in PE patients, but it is not adequate for diagnosis of PE.Öğe THE EFFECT OF CHRONIC CARBON MONOXIDE EXPOSURE ON BRAIN IN BARBECUE WORKERS(Parlar Scientific Publications (P S P), 2014) Turtay, Muhammet Gokhan; Yumrutepe, Sevgi; Kahraman, Aysegul Sagir; Bentli, Recep; Oguzturk, Hakan; Firat, Cemal; Colak, CemilThe aim of our study is to investigate whether chronic carbon monoxide (CO) exposure has effects on the brains of the people who work as barbecue workers (BWs) for a long time. Twenty males who had been working in the indoor environments of various restaurants (Group I) and 20 healthy males who were matched by age with the other group (Group 2) were included in the study. Laboratory tests were performed in both groups of people. Magnetic Resonance Spectroscopy (MRS) was applied to the people whose blood samples were taken. In Group I, significant correlations were not detected between carboxyhemoglobin (COHb) values and the variables of age, working hours, hemoglobin (Hb), white blood cell (WBC), hematocrit (HCT), platelet (PLT), mean platelet volume (MPV), pH, oxygen saturation (Sat O2) (p>0.05). In terms of Hb, WBC, HCT, PLT, MPV, pH, Sat O2, COHb, N-acetylaspartate/creatine in basal ganglion, choline/creatine in basal ganglion, N-acetylaspartate/creatine in frontal lobe periventricular white matter, choline/creatine in frontal lobe periventricular white matter variables, significant differences between Group I and Group 2 were not determined. (p>0.05). As a result of this study; it is detected that chronic exposure to CO in BWs does not have any effects on brain with respect to MRS imaging method.
