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Öğe Akciğer tüberkülozlu hastaların bronkoalveolar lavajında il-12, ifn-? ve sil-2 düzeyleri(2019) Acat, Murat; Yılmaz, VeyselAmaç: Çalışmamızda lokal immün cevabı yansıttığı düşünülen sitokin seviyelerini (İL-12, İFN-? vesİL-2) bronkoalveolar lavaj sıvısında ölçerek balgamda yayma negatif saptanan hastalar ile balgamyayması pozitif olan hastaları karşılaştırmayı amaçladık.Gereç ve Yöntemler: Çalışma retrospektif olarak dizayn edildi. Çalışmaya Ekim 1998-Şubat 1999arasında Yedikule Göğüs Hastalıkları ve Göğüs Cerrahisi Eğitim ve Araştırma Hastanesi’nde tetkik vetedavi edilen 24 tüberküloz hastası alındı. Kontrol grubu olarak diğer nedenlerle bronkoskopi yapılmışolan akciğer malignitesi veya tüberkülozu olmayan 15 hasta alındı.Bulgular: Hasta ve kontrol grupları İL-12, İFN-? ve sİL-2 düzeyleri açısından karşılaştırıldığındaİL-12 ve İFN-? düzeylerinin anlamlı şekilde farklı olduğu tespit edildi (sırasıyla p: 0,02 ve p<0,001).Sonuç: Tüberküloz hastalarının bronkoalveolar lavaj sıvılarında İFN-? düzeyinde belirgin artış tespitedilmesi önemli bir bulgudur. Bu İFN-? artışına İL-12 düzeyi artışının da eşlik etmesi bu iki sitokininlokal inflamasyon belirteci olarak da kullanılabileceğini düşündürmüştür. Bu sitokinlerin tanısalanlamda da kullanılabilirliğini araştıran daha kapsamlı çalışmalara ihtiyaç vardır.Öğe Association of Fragmented QRS with Subclinical Left Ventricular Dysfunction in Patients with Obstructive Sleep Apnea(Karger, 2015) Adar, Adem; Kiris, Abdulkadir; Bulbul, Yilmaz; Bektas, Huseyin; Acat, Murat; Casim, Hasan; Onalan, OrhanObjective: We aimed to investigate whether fragmented QRS (fQRS) is associated with subclinical left ventricular (LV) dysfunction in patients with obstructive sleep apnea (OSA). Subjects and Methods: A total of 141 patients with OSA who had normal LV ejection fraction (LVEF) were included in the study. The fQRS was defined as the presence of an additional R wave, notching of R or S wave or the presence of fragmentation in 2 contiguous electrocardiography (ECG) leads. Subclinical LV dysfunction was defined as the presence of a tissue Doppler-derived Tei index of >= 0.5 in the absence of impaired LVEF (<50%) as assessed by transthoracic echocardiography. Results: Of the 141 patients, 71 (50.4%) had subclinical LV dysfunction. Overall, the prevalence of the fQRS was 61% (86/141). Patients with fQRS had significantly higher Tei indices than those without fQRS [median 0.66, interquartile range (IQR) 0.39 vs. median 0.40, IQR 0.15, p < 0.001]. The presence of fQRS on ECG predicted subclinical LV dys-function in univariate logistic regression analysis [odds ratio (OR) 6.69, 95% confidence interval (CI) 3.10-14.43]. The association remained significant after adjusting for all potential confounders (OR 4.59, 95% CI 1.94-10.87). Conclusion: fQRS on ECG was an independent predictor of subclinical LV dysfunction in patients with OSA. This simple tool might help to identify OSA patients who could be at risk for developing overt cardiac dysfunction. (C) 2015 S. Karger AG, BaselÖğe Comparison of pirfenidone and corticosteroid treatments at the COVID-19 pneumonia with the guide of artificial intelligence supported thoracic computed tomography(Wiley, 2021) Acat, Murat; Gulhan, Pinar Yildiz; Oner, Serkan; Turan, Muhammed KamilAim We aimed to investigate the effect of short-term pirfenidone treatment on prolonged COVID-19 pneumonia. Method Hospital files of patients hospitalised with a diagnosis of critical COVID-19 pneumonia from November 2020 to March 2021 were retrospectively reviewed. Chest computed tomography images taken both before treatment and 2 months after treatment, demographic characteristics and laboratory parameters of patients receiving pirfenidone + methylprednisolone (n = 13) and only methylprednisolones (n = 9) were recorded. Pulmonary function tests were performed after the second month of the treatment. CT involvement rates were determined by machine learning. Results A total of 22 patients, 13 of whom (59.1%) were using methylprednisolone + pirfenidone and 9 of whom (40.9%) were using only methylprednisolone were included. When the blood gas parameters and pulmonary function tests of the patients were compared at the end of the second month, it was found that the FEV1, FEV1%, FVC and FVC% values were statistically significantly higher in the methylprednisolone + pirfenidone group compared with the methylprednisolone group (P = .025, P = .012, P = .026 and P = .017, respectively). When the rates of change in CT scans at diagnosis and second month of treatment were examined, it was found that the involvement rates in the methylprednisolone + pirfenidone group were statistically significantly decreased (P < .001). Conclusion Antifibrotic agents can reduce fibrosis that may develop in the future. These can also help dose reduction and/or non-use strategy for methylprednisolone therapy, which has many side effects. Further large series and randomised controlled studies are needed on this subject.Öğe Comparison of the Fractional Exhaled Nitric Oxide Levels in Adolescents at Three Schools Located Three Different Distances from a Large Steel Mill(Hindawi Ltd, 2017) Acat, Murat; Aydemir, Yusuf; Yazjcj, Onur; Turgut, Mahmut; Cortuk, Mustafa; Cakar, Murat; Yasar, ZehraObjectives. Exposure to ambient metals and air pollutants in urban environments has been associated with impaired lung health and inflammation in the lungs. Fractional exhaled nitric oxide (FeNO) is a reliablemarker of airway inflammation. In this study, we aimed to compare the FeNO levels of three schools that have different distances from iron and steel industry zone for assessing the effects of heavy metals and air pollution on their respiratory health. Methods. Pulmonary function test and FeNO measurements were evaluated in 387 adolescents in three schools which have different distance from plant. Results. FeNO levels were significantly higher in School I (n = 142; 18.89 +/- 12.3ppb) and School II (n = 131; 17.68 +/- 7.7 ppb) than School III (n = 114; 4.28 +/- 3.9 ppb). Increased FeNO concentration was related to the distance of iron and steel industry zone in young adults. Conclusion. The FeNO concentrations in school children were inversely proportional to the distance from the steel mill. There are needed some studies that can evaluate the safe distance and legislation must consider these findings.Öğe Comparison of Tocilizumab and Anakinra in the Treatment of COVID-19: A Single-Center Experience(Duzce Univ, Fac Medicine, 2022) Acat, Murat; Cavdar, Ozben; Tezce, Ahmet; Acat, Bengisu PinarAim: The aim of this study was to examine whether a difference between endotracheal intubation, non-invasive mechanical ventilation, high flow oxygen therapy requirements and 28-day mortality rate in severe and critical coronavirus disease 2019 (COVID-19) patients receiving anakinra and tocilizumab treatment. Material and Methods: A total of 70 patients infected with COVID-19, who were treated with tocilizumab and anakinra from April 2020 to March 2021 at Karabuk Training and Research Hospital, were recruited in this retrospective study. Data on patient demographics, comorbidities, treatments, clinical outcomes of the patients' and hemogram findings were retrieved from hospital records. Results: The mean age of the patients was 61.34 +/- 11.8 years. Of the 70 patients, 12 (17.1%) were female and 58 (82.9%) were male. Severe and critical COVID-19 cases were evident in 48 (68.6%), and 22 (31.4%) patients, respectively. The mortality rate in 28 days was not statistically significantly different between the tocilizumab and anakinra groups (p=0.999). Both the necessity of high flow oxygen therapy and non-invasive mechanical ventilation were lower in the tocilizumab group than in the anakinra group (p<0.001, and p=0.002, respectively), while there was no statistically significant difference in the necessity of intubation between the two groups (p=0.999). The length of stay was also significantly shorter in the tocilizumab group (p=0.027). Conclusion: High flow oxygen therapy, non-invasive mechanical ventilation requirements, and length of stay were significantly lower than anakinra in the tocilizumab group. Excessive inflammatory response with cytokine storm features causes severe disease course and worsens prognosis in COVID-19.Öğe Diagnosis of Pulmonary Hydatid Cyst by Bronchoscopy(Lippincott Williams & Wilkins, 2015) Yasar, Zehra; Acat, Murat; Turgut, Erhan; Onaran, Hilal; Dincer, Huseyin Erhan; Arda, Naciye; Cetinkaya, ErdoganHydatid cyst is a parasitic infestation caused by Echinococcus granulosus. Lungs are the second most common site of involvement after liver. The diagnosis of complicated pulmonary hydatid cysts may not be easy because hydatid cyst disease mimics tuberculosis, lung cancer, empyema, or abscess. Fiberoptic bronchoscopy can be a valuable tool in the diagnosis of the infestation by visualization of hydatid cyst membrane. Here, we report the case of a 33-year-old woman who presented with hemoptysis and chest discomfort and was diagnosed with a hydatid cyst by fiberoptic bronchoscopy.Öğe Diagnostic value and safety of medical thoracoscopy in the management of exudative pleural effusion(2016) Özgül, Mehmet Akif; Çetinkaya, Erdoğan; Tanrıverdı, Elif; Çörtük, Mustafa; Acat, Murat; Gül, Sule; Seyhan, Ekrem CengizObjective: Medical thoracoscopy is a minimally invasive procedure that is performed by experienced pulmonologists under local anesthesia and conscious intravenous sedation. It allows direct observation and evaluation of the pleural space. Our aim is to evaluate the diagnostic efficacy and safety of this procedure while presenting our results of medical thoracoscopy performed by rigid thoracoscopy in our clinic.Methods: Thirty-seven patients who had gone thorough medical thoracoscopy between March 2011 and August 2014 were evaluated retrospectively.Results: Of these 37 patients, 26 were male and the average age was 50.94±15.38 years. Fourteen patients had right-sided pleural effusion, whereas 23 had left-sided pleural effusion. Closed pleural biopsy was performed previously in 16 patients with no diagnostic results. In 36 patients (97.3%), a specific diagnosis was achieved. One patient, diagnosed as lymphocytic pleuritis by medical thoracoscopy, underwent decortication and the pathology was consistent with biphasic malignant pleural mesothelioma. Another patient, diagnosed as chronic nonspecific pleuritis with medical thoracoscopy, underwent decortication and the diagnosis was fibrinous pleuritis characterized by extensive fibrosis. Three patients had expansion defects during the post-operative period. Hemothorax occurred in one patient that died of respiratory failure on day 34 of hospitalization. The median length of stay in the hospital after the procedure was 5 days (1-34).Conclusion: Medical thoracoscopy is a secure procedure with high diagnostic value in the management of exudative pleural effusionÖğe Diagnostic Value and Safety of Medical Thoracoscopy in the Management of Exudative Pleural Effusion(Wolters Kluwer Medknow Publications, 2016) Ozgul, Mehmet Akif; Cetinkaya, Erdogan; Tanriverdi, Elif; Cotuk, Mustafa; Acat, Murat; Gul, Sule; Seyhan, Ekrem CengizObjective: Medical thoracoscopy is a minimally invasive procedure that is performed by experienced pulmonologists under local anesthesia and conscious intravenous sedation. It allows direct observation and evaluation of the pleural space. Our aim is to evaluate the diagnostic efficacy and safety of this procedure while presenting our results of medical thoracoscopy performed by rigid thoracoscopy in our clinic. Methods: Thirty-seven patients who had gone thorough medical thoracoscopy between March 2011 and August 2014 were evaluated retrospectively. Results: Of these 37 patients, 26 were male and the average age was 50.94 +/- 15.38 years. Fourteen patients had right-sided pleural effusion, whereas 23 had left-sided pleural effusion. Closed pleural biopsy was performed previously in 16 patients with no diagnostic results. In 36 patients (97.3%), a specific diagnosis was achieved. One patient, diagnosed as lymphocytic pleuritis by medical thoracoscopy, underwent decortication and the pathology was consistent with biphasic malignant pleural mesothelioma. Another patient, diagnosed as chronic nonspecific pleuritis with medical thoracoscopy, underwent decortication and the diagnosis was fibrinous pleuritis characterized by extensive fibrosis. Three patients had expansion defects during the post-operative period. Hemothorax occurred in one patient that died of respiratory failure on day 34 of hospitalization. The median length of stay in the hospital after the procedure was 5 days (1-34). Conclusion: Medical thoracoscopy is a secure procedure with high diagnostic value in the management of exudative pleural effusion.Öğe Efficacy and safety of endobronchial ultrasound-guided transbronchial needle aspiration through the pulmonary arteries for the diagnosis of left hilar lesions(Turkish Assoc Tuberculosis & Thorax, 2018) Cetinkaya, Erdogan; Cortuk, Mustafa; Turan, Demet; Tanriverdi, Elif; Acat, Murat; Ozgul, Mehmet AkifIntroduction: Endobronchial ultrasonography (EBUS) is an endoscopic method that aids needle aspiration to see the bronchial wall and adjacent tissues with an ultrasound probe. Pulmonary arteries are rarely present between the bronchus wall and the tissue. In this case, it was necessary to make a selection between invasive processes and transbronchial needle aspiration (TBNA) through the pulmonary artery. There are few case reports about the safety of TBNA through the pulmonary artery. We aimed to present the results of EBUS guided TBNA through the pulmonary arteries. Materials and Methods: The data on four cases (three men) in whom EBUS guided TBNA was performed through the pulmonary artery between August 2010 and December 2015 were reviewed retrospectively. Procedures were conducted under local anesthesia and conscious sedation. For TBNA, 22-gauge needles were used. Cases were monitored for 24 hour after the procedures. Antibiotic prophylaxis and onsite cytopathology were not used. Results: All lesions existed were on the left hilar localization. Two of the diagnosed cases were carcinoma and one was the granulomatous lymphadenitis. We were not able to diagnose the last case. No complication was observed in any cases during the procedure. Conclusion: EBUS guided TBNA through the pulmonary arteries at left hilar lesions is safe. The rate of diagnoses from the tissues obtained is high. No special preparation is needed for the cases have no the pulmonary hypertension.Öğe Evaluation of both expression and serum protein levels of caspase-8 and mitogen-activated protein kinase 1 genes in patients with different severities of COVID-19 infection(Springer, 2023) Acat, Murat; Gulhan, Pinar Yildiz; Eroz, Recep; Ertinmaz Ozkan, Aysegul; Koca, Oguzhan; Cinar, CanerAimThe current study aimed to evaluate the effects of caspase-8 (CASP8) and mitogen-activated protein kinase 1 (MAPK1) gene expression levels and their products on preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.MethodsA total of 40 patients (men, 15 [37.5%]; women, 25 [62.5%]) with COVID-19 infection were included in the current study. The patients were divided into four main groups based on disease severity: mild (n = 7), moderate (n = 10), severe (n = 14), and critical (n = 9). Individuals aged < 18 years and pregnant women were excluded. Patients were classified according to the World Health Organization (WHO) classification system (WHO/2019-nCoV/clinical/2021.1).ResultsConsidering all groups, statistically significant differences were detected among all groups for both CASP8(2-Delta Delta Ct) (p = 0.006) and MAPK1 2(-Delta Delta Ct) values (p = 0.015). Moreover, statistically significant differences were detected between mild and moderate (p = 0.013), moderate and critical (p = 0.018), and severe and critical (p = 0.023) groups for lymphocytes.ConclusionThe CASP8/MAPK1 expression levels and/or its products are essential in preventing injury caused by COVID-19 infection. They play crucial roles in maintaining cellular homeostasis and viability. Furthermore, CASP8/MAPK1 levels can provide information about disease severity.Öğe Evaluation of the Effect of Comorbid Bronchiectasis on Quality of Life in Patients with Chronic Obstructive Pulmonary Disease(Duzce Univ, Fac Medicine, 2022) Yilmaz, Cansu; Acat, Murat; Oner, Serkan; Inci, Habibe; Adahan, DidemObjective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on quality-of-life in patients with Chronic Obstructive Pulmonary Disease (COPD). Method: 103 patients were diagnosed with COPD were included in our study. Spirometric measurements were made. The following measurement tools were used to collect data: 6-Minute Walk Test (6MWT), Modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), and Short Form 36 (SF-36) quality-of-life questionnaire. Furthermore, all the patients' high Resolution Computed Tomography (HRCT) images for the last three years were included in the study. Result: 93.2% of the patients were male, with a mean age of 64.79 +/- 9.35 years. It was found that SGRQ and SF-36 quality-of-life scores decreased by half in all the patients compared to normal ones. The volume/forced vital capacity (FEV1/FVC) values in the first second of forced expiration were significantly lower in the group with bronchiectasis. A significant correlation was found to exist between the patients' mMRC dyspnea scale and CAT scores, 6MWT distances, and all subscales of SGRQ and SF-36. In addition, a significant correlation was also found to exist between FEV1 values and all subscales of SGRQ, and between subscales of SF-36. Conclusion: In our study, when we compared the quality-of-life scores of the patients with COPD and bronchiectasis with those with COPD alone, we found that the quality-of-life of both groups was impaired, but there was no significant difference between them.Öğe Evaluation of the effect of comorbid bronchiectasis on quality of life in patients with chronic obstructive pulmonary disease(2022) Yılmaz, Cansu; Acat, Murat; Öner, Serkan; İnci, Habibe; Adahan, DidemObjective: The objective of this study was to evaluate the effect of comorbid bronchiectasis on quality-of-life in patients with Chronic Obstructive Pulmonary Disease (COPD). Methods: 103 patients were diagnosed with COPD were included in our study. Spirometric measurements were made. The following measurement tools were used to collect data: 6-Minute Walk Test (6MWT), Modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), and Short Form 36 (SF-36) quality-of-life questionnaire. Furthermore, all the patients’ high Resolution Computed Tomography (HRCT) images for the last three years were included in the study. Results: 93.2% of the patients were male, with a mean age of 64.79 ± 9.35 years. It was found that SGRQ and SF-36 quality of life scores decreased to approximately half of the full score in all patients. The volume/forced vital capacity (FEV1/FVC) values in the first second of forced expiration were significantly lower in the group with bronchiectasis. A significant correlation was found to exist between the patients’ mMRC dyspnea scale and CAT scores, 6MWT distances, and all subscales of SGRQ and SF-36. In addition, a significant correlation was also found to exist between FEV1 values and all subscales of SGRQ, and between subscales of SF- 36. Conclusions: In our study, when we compared the quality-of-life scores of the patients with COPD and bronchiectasis with those with COPD alone, we found that the quality-of-life of both groups was impaired, but there was no significant difference between them.Öğe Factors affecting tnf-? decrease in covid-19 patients(2024) Gülhan, Muhammet; Alpay, Merve; Yıldız, Sule; Yaslı, Nevra Ezgi; Acat, Murat; Kahraman, Gözde; Arbak, PeriAim: Tumor necrosis factor-alpha (TNF-?) have several functions, including cell survival, differentiation, and proliferation. TNF-? may effect the cell death during the cytokine storm that occurred during COVID-19 infection. We aimed to investigate, the factors that affects the TNF-? decrease in COVID-19 patients. Material and Methods: Totally 44 individuals with COVID-19 infection were included the study. Blood counts, biochemical examinations and D-dimer examinations were obtained. Comorbidities and initial symptoms of the patients were recorded. TNF-?, CRP and ferritin values were measured twice on the 1st and 7th days of hospitalization. The change in this values were examined according to comorbidities, initial symptoms and steroid usage. Results: Of a total of 44 patients, 56.8% were male (25/44) and 43.2 % were female (19/44). TNF-? decrease was found to be statistically significant in non-diabetic patients, while TNF-? decrease was found to be insignificant in diabetic patients. CRP decrease was found to be statistically significant in both diabetic and non-diabetic patients while ferritin decrease was insignificant in both diabetic and non-diabetic patients. While TNF-? and CRP decreased statistically significantly in those without lung disease, it was observed that both TNF-? and CRP decreases were not significant in those with lung disease. The decrease in TNF-? and CRP was statistically insignificant in those who did not treated with steroids, while the decrease in TNF-? and CRP was significant in those who treated with steroids. Conclusion: Steroids decreases the TNF-? levels. TNF decrease is not significant in those with diabetes and lung disease.Öğe Fibulins: a new biomarker for pulmonary thromboembolism?(Taylor & Francis Ltd, 2020) Acat, Murat; Dikis, Ozlem Sengoren; Dulger, Seyhan Us; Akbay, Ertan; Karakaya, Ekrem; Haskul, Ismail; Chousein, Efsun GoncaObjectives Fibulin-1, -2, -4, and -5 have important role in several vascular diseases. We aimed to investigate if fibulin-4 and -5 can be used as a biomarker for pulmonary thromboembolism (PTE). Methods This is a prospective case control study. Thirthy patients diagnosed with PTE and 31 in the control group. Data on demographic characteristics, length of hospital stay, blood cell counts, troponin and BNP levels, arterial blood gases, radiological reports, indication for thromboembolitic treatment, intensive care unit (ICU) requirement, and loss of life were recorded for the patients group. Serum Fibulin-4 and Fibulin-5 levels were measured. Results Fibulin 4 levels correlated positively with female gender (p < .01, r = 0.433). Positive results were found in 14 (46.7%) patients for PESI.0.1; in 7 (23.3%) patients for D-dimer; in 7 (23.3%) patients for troponin-I; in 7(23.3%) patients for BNP. Median values for Fibulin 4 level were significantly higher in patients positive for BNP. Fibulin-5 level was found to be correlated with the presence of embolism (p = .041, r = 0.263). Conclusions Fibulin-4 and -5 have been shown to be relevant to cardiovascular biology and diseases. Experimental studies and observations in humans show that they may play a role in several cardiovascular diseases particularly pulmonary embolism.Öğe General features of patients with Pulmonary Langerhans Cell Histiocytosis followed in our instution(Turkish Assoc Tuberculosis & Thorax, 2018) Acat, Murat; Tanriverdi, Elif; Ugur Chousein, Efsun Gonca; Demirkol, Baris; Yildirim, Binnaz Zeynep; Turan, Demet; Ozgul, Mehmet AkifIntroduction: Pulmonary Langerhans Cell Histiocytosis (PLCH) is a rare disease affecting young smokers. It is more common between the ages of 20-40 and equals the male/female ratio. Lung biopsy is the most useful methods for diagnosis. The first treatment is to quit smoking. Corticosteroids or chemotherapeutic agents can be used in severe progressive cases despite of quiting smoking. The patients with PLCH followed in our clinic were assessed with general clinical features in the light of the literature. Materials and Methods: We retrospectively evaluated patients with PLCH in our clinic between January 1999 and June 2017. Results: The female and male distribution of the 21 patients was 11/10. The average age was 35.04 +/- 11.78 years. All patients were active smokers at the time of admission. The most common symptom was dyspnea. The most common finding in the pulmonary function tests was obstructive ventilatory defect. The DLCO value of the 70% patient in the carbonmonooxid diffusion test was below 80%. The most common pathologic findings detected in high-resolution chest tomography (HRCT) were cystic lesions involving bilateral upper and middle areas. There were 3 (14%) patients with pneumothorax at the time of admission and 6 (28.5%) patients with pneumothorax history before. The most common diagnostic method was open lung biopsy. All the patients quit cigarette after the diagnosis. There were 6 patients using steroid therapy, 1 patient receiving steroid and bosentan therapy, and 1 patient made pleurectomy due to recurrent pneumothorax. Lung transplantation was done to patient who received combined bosentan treatment with steroids. Conclusion: PLCH is a rare disease and should be considered in young, smokers with spontaneous pneumothorax and cystic lung disease in the differential diagnosis. As more diffusions are affected in patients, respiratory functions for follow-up should be evaluated with diffusion tests. It is essential to quit smoking in therapy.Öğe Intrathoracic migration of a Kirschner wire(Oxford Univ Press, 2014) Ozarslan, Fatma; Arikan, Osman; Acat, Murat; Arikan, Muge; Temel, VolkanKirschner (K) wires can easily migrate, resulting in serious complications. We report a 49-year-old woman who had a rare and late complication related to the migration of K wire. It had been used for left hip replacement 8 years ago. The patient admitted to our hospital with breathing-dependent chest pain and increasing dyspnea for similar to 2 h. Chest X-ray and chest computed tomographic scans revealed the presence of a metallic image of similar to 5-6 cm in the right hemithorax. There was a large hemothorax but no pneumothorax. A right thoracotomy was performed and the wire was removed without complications. Surprisingly, no injury was noted to any intervening abdominal structure intra-operatively. Patients, who are treated with K wire, should be informed of the risk of wire migration and should undergo regular postoperative follow-ups including radiography.Öğe The Monocyte/HDL Cholesterol Ratio in Obstructive Sleep Apnea Syndrome(Galenos Yayincilik, 2019) Acat, Murat; Yazici, OnurObjective: Obstructive Sleep Apnea syndrome (OSAS) is the most common condition among sleep-related respiratory disorders. The etiology is not clear. However, systemic and local inflammation in the respiratory tract of the patients has been acknowledged. Monocytes and macrophages play the critical role in the inflammation process. These cells participate in the release of the proinflammatory cytokines in inflammation sites. High-density lipoprotein (HDL) cholesterol is a molecule with an anti-inflammatory effect. Monocyte/HDL cholesterol ratio (MHR) is an inflammation marker being used recently. In our study, we aimed to compare inflammation marker levels between patients diagnosed with OSAS with subsequent polysomnography and the non-OSAS group, determine the relationship between the severity of OSAS and MHR and, investigate the utility of the MHR for diagnosing OSAS. Materials and Methods: The data from the patients' files who had polysomnography due to OSAS symptoms in our unit between July 2017 and December 2017 have been retrospectively analyzed, and polysomnography results were recorded. Demographic data and the results of biochemistry and complete blood count panels of patients with OSAS and who were not also were recorded. Results: Out of 147 patients who underwent polysomnography in the period identified, 104 were diagnosed with OSAS. Monocyte count and MHR values were significantly high (p<0.0001 in both) and HDL levels were significantly low (p=0.03) in OSAS group. There was also a moderately significant positive correlation between apnea-hypopnea index (AHI) and MHR (p<0.0001, r=0.411). Conclusion: MHR may be a useful tool for diagnosing OSAS. Because of the positive correlation between MHR and AHI which represents the severity of the disease, MHR may be used for the classification of OSAS.Öğe Moxifloxacin related thrombocytopeniae: A case report(Turkish Assoc Tuberculosis & Thorax, 2016) Cortuk, Mustafa; Benli, Ali Ramazan; Koroglu, Mustafa; Yazici, Onur; Acat, Murat; Casim, Hasan; Cetinkaya, ErdoganDrug-induced thrombocytopenia can be caused by various medications, most frequently, antibiotics. There have been reports of thrombocytopenia cases due to the usage of quinolone antibiotics, although moxifloxacin-related thrombocytopenia has been reported very rarely. The case is here presented of a 60-year old male with chronic obstructive pulmonary disease who presented with complaints of progressively worsening dyspnea. After hospitalization, progressive thrombocytopenia was detected which had started on the 3rd day of moxifloxacin treatment. Other causes of thrombocytopenia were excluded and the thrombocyte count returned to normal after discontinuation of moxifloxacin.Öğe Moxifloxacin related thrombocytopeniae: a case report*(2016) Çörtük, Mustafa; Benli, Ali Ramazan; Köroglu, Mustafa; Yazıcı, Onur; Acat, Murat; Casım, Hasan; Çetinkaya, Erdoğanİlaç kullanımına bağlı trombositopeniler çeşitli ilaçlarla ortaya çıkabilir. Bu tablo sıklıkla antibiyotiklere bağlı olarak gelişmektedir. Kinolon grubu antibiyotik kullananlarda trombositopeni bildirilmiştir. Ancak moksifloksasine bağlı trombositopeni olguları nadirdir. Sunulan 60 yaşındaki erkek hastada kronik obstrüktif akciğer hastalığı (KOAH) mevcuttu ve giderek artan nefes darlığı nedeniyle başvurdu. Hastaneye yatırılan olguda moksifloksasin kullanımının üçüncü gününde başlayan trombositopeni saptandı. Diğer trombositopeni nedenlerinin dışlandığı hastada moksifloksasinin kesilmesinden sonra trombosit düzeyi normale döndü.Öğe Müsabaka arası içilen maden suyunun serum elektrolit düzeylerine etkisi(2012) Kara, Ersan; Akıl, Mustafa; Andsoy, Işıl Işık; Acat, Murat; Güngör, TuğbaBu çalışma, müsabaka arası içilen maden suyunun serum elektrolit düzeylerinde meydana getirdiği değişikliklerin incelenmesi amacıyla yapılmıştır. Çalışmaya bölgesel liglerde oynayan 16 erkek futbolcu dâhil edilmiştir. Futbolcular deney (n=9; yaş 21.30±0.83 yıl, ağırlık 72.40±1.64 kg ve boy 178.20±0.08 cm ) ve kontrol (n=7; yaş 22.50±0.98 yıl, ağırlık 69.90±2.27 kg, boy 177.90±0.07 cm) olmak üzere iki gruba ayrılmıştır. Deney grubu maden suyu kontrol grubu su içmiştir. İçecekler Müsabakanın devre arasında ve kan alımının hemen öncesinde verilmiştir. Araştırma kapsamında sporculardan; müsabaka öncesi, müsabaka arası ve müsabakadan hemen sonra olmak üzere 3 kez ve her seferde 5 cc olacak şekilde kan alınmıştır. Alınan kan örneklerinde Sodyum (Na), Potasyum (K), Klor (Cl) parametreleri incelenmiştir. Tüm değişkenlerin tanımlayıcı istatistikleri yapıldıktan sonra ölçüm zamanının impedans ve reaktans üzerine etkisi tekrarlı ölçümlerde ANOVA ile test edilmiştir. Farkların hangi zamanlarda oluştuğu Bonferroni çoklu karşılaştırma testi, deney ve kontrol grupları arasındaki farklılıkların değerlendirilmesinde ise Independent Samples t-testi kullanılmıştır. İncelenen Sodyum, Potasyum, Klor parametrelerinin kendi aralarında, deney ve kontrol grubu karşılaştırmalarında anlamlı farklılıklar (p < 0.05) bulunmuştur. Yapmış olduğumuz çalışmanın sonuçları değerlendirildiğinde; 10°C hava koşullarında oynanan Futbol maçında sıvı azalmasına bağlı olarak elektrolit kaybının yaşandığı, devre arası 10°C sıcaklığında içilen Maden Suyunun, Doğal Kaynak suyuna oranla elektrolit seviyelerinin korunmasında faydalı olabileceği söylenebilir
