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Emergency admissions due to swallowed foreign bodies in adults

World Journal of Gastroenterology 2013年第38期19卷 6447-6452页

作者： Bülent Erbil mehmet ali karaca mehmet ali Aslaner Zaur Ibrahimov mehmet Mahir Kunt Erhan Akpinar mehmet Mahir zmen Department of Emergency Medicine Faculty of MedicineHacettepe University06100 AnkaraTurkey Department of Radiology Faculty of MedicineHacettepe University06100 AnkaraTurkey Department of General Surgery Faculty of MedicineHacettepe University06100 AnkaraTurkey

AIM:To study a retrospective analysis of patients who presented to the emergency departments(ED)with complaints related to foreign body ***:Patients older than 16 years of age who presented to the ED between January 1stand December 31stof 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient ***:A total of 100 patients presented with a complaint of foreign body ingestion during the study ***,an X-ray was performed on 75 patients,and a fiberoptic evaluation was performed on45 patients.A foreign body was detected in 46(46%)*** diagnostic yield of the X-ray was 27(36%)out of 75 patients,while the diagnostic yield of the fiberoptic evaluations was 21(47%)out of 45 *** detected foreign bodies were mostly located in the esophagus(17 out of 46 foreign bodies detected).When the types of ingested foreign bodies were evaluated,52(52%)patients reported ingesting food,and19(19%)patients reported swallowing *** X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two *** 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation,the foreign material was detected and ***:Plain radiography is helpful in the localization of radiopaque swollen foreign bodies,while fiberoptic methods are useful as both diagnostic and therapeutic tools,regardless of radiopacity.

关键词： Foreign body Ingestion Gastrointestinal tract Endoscopy Emergency

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Predictors of poor outcome in gastrointestinal bleeding in emergency department

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World Journal of Gastroenterology 2016年第16期22卷 4219-4225页

作者： Ender Kaya mehmet ali karaca Deniz Aldemir M Mahir Ozmen Dr. Nafiz Korez State Hospital Sincan 06932 Ankara Turkey Emergency Medicine Department Faculty of Medicine Hacettepe University Sihhiye 06100 Ankara Turkey General Surgery Department Faculty of Medicine Hacettepe University Sihhiye 06100 Ankara Turkey

AIM: To determine the prognostic risk factors of gastrointestinal bleeding in emergency department ***: The trial was a retrospective single-center study involving 600 patients over 18-years-old and carried out with approval by the Institutional Ethics Committee. Patient data included demographic characteristics, symptoms at admission, past medical history, vital signs, laboratory results, endoscopy and colonoscopy results, length of hospital stay, need of intensive care unit(ICU) admission, and mortality. Mortality rate was the principal endpoint of the study, while duration of hospital stay, required interventional treatment, and admission to the ICU were secondary ***: The mean age of patients was 61.92-yearsold. Among the 600 total patients, 363(60.5%) underwent upper gastrointestinal endoscopy and the most frequent diagnoses were duodenal ulcer(19.2%) and gastric ulcer(12.8%). One-hundred-and-fifteen(19.2%) patients required endoscopic treatment, 20(3.3%) required surgical treatment, and 5(0.8%) required angiographic embolization. The mean length of hospital stay was 5.21 ± 5.85 d. The mortality rate was 6.3%. The ICU admission rate was 5.3%. Patients with syncope, higher blood glucose levels, and coronary artery disease had significantly higher ICU admission rates(P = 0.029, P = 0.043, and P = 0.002, respectively). Patients with low thrombocyte levels, high creatinine, high international normalized ratio, and high serum transaminase levels had significantly longer hospital stay(P = 0.02, P = 0.001, P = 0.019, and P = 0.005, respectively). Patients who died had significantly higher serum blood urea nitrogen and creatinine levels(P = 0.016 and P = 0.038), and significantly lower mean blood pressure and oxygen saturation(P = 0.004 and P = 0.049). Malignancy and low Glasgow coma scale(GCS) were independent predictive factors of ***: Prognostic factors for gastrointestinal bleeding in emergency room cases are malignancy, hyp

关键词： Gastrointestinal bleeding Poor prognosis Mortality Emergency department Kidney function Malignancy

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Clinical efficacy and drug resistance of anti-epidermal growth factor receptor therapy in colorectal cancer

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World Journal of Gastrointestinal Oncology 2016年第1期8卷 1-7页

作者： hakan kocoglu fatih mehmet velibeyoglu mustafa karaca deniz tural department of medical oncology bakirkoy education and research hospital34900 IstanbulTurkey department of medical oncology gazi university faculty of medicine06500 AnkaraTurkey

Colorectal cancer(CRC) ranked third in cancer related death and its incidence has been increasing worldwide. In recent decades important therapeutic advances have been developed in treatment of metastatic CRC(mCRC), such as monoclonal antibodies against epidermal growth factor receptor(anti-EGFR), which provided additional clinical benefits in mCRC. However, anti-EGFR therapies have limited usage due to approximately 95% of patients with KRAS mutated mCRC do not response to anti-EGFR treatment. Thus, KRAS mutation is predictive of nonresponse to anti-EGFR therapies but it alone is not a sufficient basis to decide who should not be received such therapies because; approximately fifty percent(40%-60%) of CRC patients with wild-type KRAS mutation also have poor response to anti-EGFR based treatment. This fact leads us to suspect that there must be other molecular determinants of response to anti-EGFR therapies which have not been identified yet. Current article summarizes the clinical efficacy of anti-EGFR therapies and also evaluates its resistance mechanisms.

关键词： Colorectal cancer Epidermal growth factorreceptor KRAS mutation Anti-epidermal growth factorreceptor antibody Drug resistance

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Fourier analysis of corneal Scheimpflug imaging:clinical use in keratoconus

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International Journal of Ophthalmology(English edition) 2021年第12期14卷 1963-1969页

作者： Dorukcan Akincioglu Gokhan Ozge Onder Ayyildiz Gokcen Gokce Umut karaca Fatih mehmet Mutlu Ataturk State Hospital Antalya 07040Turkey Department of Ophthalmology Gulhane School of MedicineUniversity of Health SciencesAnkara 06010Turkey Department of Ophthalmology Gülhane Training and Research HospitalAnkara 06010Turkey Memorial Hospital Kayseri 38010Turkey Department of Ophthalmology Suleyman Demirel UniversityIsparta 32040Turkey

AIM:To evaluate the clinical use of Fourier analysis of videokeratography data in the diagnosis and follow-up of keratoconus(KC).METHODS:We conducted a chart review of consecutive patients presented to our cornea clinic.A team of two experienced cornea specialists divided the patients into three groups:normal cornea,forme fruste KC(FFKC),and clinical *** exclusion criteria were a history of previous ocular surgery,any accompanying corneal pathology other than KC,high myopia(>6.00 diopters),amblyopia,pregnancy,breastfeeding,or any current autoimmune *** data of Fourier series harmonic analysis were evaluated for their diagnostic capacity using the receiver operating characteristic(ROC)curve.A binary logistic regression analysis was also conducted to construct a diagnostic model.A total of 259 eyes showed progression in the clinical KC group and underwent a combination of accelerated corneal collagen cross-linking and topographyguided customized treatment with an excimer ***:The study included 1262 eyes(618 normal,530 KC,and 114 FFKC)of 1262 *** observed that maximum decentration(MaxDec)was almost as good as maximum keratometry(Kmax)in detecting progressive *** area under the curve(AUC)was 0.95 for KC[95%confidence interval(CI):0.93-0.96]and 0.84 for FFKC(95%CI:0.79-0.88).Higher predictive accuracy was obtained using a model combining the spherical component,MaxDec,irregularity,and regular astigmatism in the center of the cornea(AUC:0.97;sensitivity:89%,and specificity:96%).CONCLUSION:Decentration,Kmax,and posterior radii of curvatures from a 3.0-mm optical zone centered on the thinnest point of the cornea provide the highest accuracy with low reproducibility of Kmax.

关键词： Fourier keratoconus Scheimpflug imaging tomography topography

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Anti-pancreatic antibody in Turkish patients with inflammatory bowel disease and first-degree relatives

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World Journal of Gastroenterology 2010年第45期16卷 5732-5738页

作者： Huseyin Demirsoy Kamil Ozdil Ozdal Ersoy Besir Kesici Cetin karaca Canan Alkim Nihat Akbayir Levent Kamil Erdem mehmet Derya Onuk Hulya Tugrul Beyzadeoglu Department of Gastroenterology Sisli Etfal Training and Research Hospital34377 IstanbulTurkey Hulya Tugrul Beyzadeoglu Institute of Hygiene34020 IstanbulTurkey

AIM: To identify the role of anti-pancreatic antibody (PAB) in the diagnosis of inflammatory bowel diseases (IBD) among Turkish patients, and its frequency in firstdegree ***: PAB and anti-Saccharomyces cerevisiae (ASCA) were examined in serum samples of 214 subjects including patients with Crohn's disease (CD, n = 64), ulcerative colitis (UC, n = 63), first-degree relatives of patients with CD (n = 25), first-degree relatives of patients with UC (n = 28),and a control group with gastrointestinal symptoms other than (IBD) (n = 34) by indirect immunofluorescence Positivity of PAB and ASCA was compared in terms of Vienna classification, disease activity and medications ***: In terms of PAB positivity, no difference was found between patients with CD (14.1%) and UC (7.9%) however, significant difference was observed between patients with CD and subjects in the control group (P 150 (P < 0.05).CONCLUSION: PAB is valuable in the diagnosis of IBD rather than CD, but cannot be used alone for diagnostic purposes. PAB is not superior to ASCA in CD diagnosis and in detecting CD among relatives of patients with CD.

关键词： Anti-pancreatic antibody Anti-Saccharomyces cerevisiae antibody Crohn’s disease Ulcerative colitis Inflammatory bowel disease

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A novel model of retinopathy of prematurity in normobaric hyperoxic conditions

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International Journal of Ophthalmology(English edition) 2016年第9期9卷 1265-1270页

作者： Taner Ozgurtas Sercan Tekin Fatih Yesildal Umut karaca Fevzi Nuri Aydin Muhammed Talha Ugurlu mehmet Ozler Hakan Durukan Department of Medical Biochemistry Gulhane Military Medical Academy Ankara 06010 Turkey School of Medicine Gulhane Military Medical AcademyAnkara 06010 Turkey Department of Medical Biochemistry Diyarbakir Military Hospital Diyarbakir 21100 Turkey Department of Ophthalmology Isparta Military HospitalIsparta 32040 Turkey Department of Biochemistry Sirnak Military HospitalSimak 73000 Turkey Department of Physiology Gulhane Military Medical Academy Ankara 06010 Turkey Department of Ophthalmology Gulhane Military Medical Academy Ankara 06010 Turkey

AIM：To examine changes in retinal vasculature after treatment with different oxygen concentrations from common retinopathy of prematurity（ROP） models and to determine a novel and practical ROP ***：A sample of 14 newborn Sprague-Dawley rats was *** study group（n=7） was exposed to95%oxygen for 4h per day followed by normoxic laboratory conditions for 20 *** cycle was repeated for 14 *** control group（n=7） was subjected to normobaric normoxic *** postnatal day 14（P14）,the two groups were placed in room air for *** P21,the two groups were examined using indirect *** eyes were enucleated for immunofluorescence（IF） staining of the vasculature of retinas and analysis of vascular endothelial growth factor（VEGF）,hypoxia inducible factor-1 alpha（HIF-1α）,placental growth factor（PLGF） in vitreous humor,and then the rats were sacrificed by *** procedures were repeated using another litter of 14 ***：In the study group and under normobaric hyperoxic conditions,retinal neovascularization and peripheral avascular retina were determined in 85%of the rats through indirect ophthalmoscopic *** IF staining of retina of the study group showed retarded peripheral vascular *** difference between the two groups for VEGF,HIF-1α and PLGF concentrations of vitreous humor was statistically significant（P=0.003,0.007,0.027 respectively）.CONCLUSION：Fluctuating oxygen concentrations are primarily responsible for retinal *** new ROP model is practical and applicable for all retinal neovascularization studies,considering the laboratory procedures.

关键词： retinopathy of prematurity vascular endothelial growth factor hypoxia inducible factor-1 alpha placental growth factor fundoscopy retina staining

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Timing of Carotid Endarterectomy: Perioperative Outcome According to Index Event to Operation Room Time

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Surgical Science 2014年第10期5卷 411-417页

作者： mehmet Kalender Ahmet Nihat Baysal Ata Niyazi Ecevit Okay Güven karaca mehmet Tasar Salih Salihi Cardiovascular Surgery Department Konya Education and Research Hospital Konya Turkey Cardiovascular Surgery Department Duzce University Medical School Hospital Duzce Turkey Surgery Department Ankara University Medical School Hospital Ankara Turkey Cardiovascular Surgery Department Nigde State Hospital Nigde Turkey

Aim:?Carotid endarterectomy (CEA) is the choice of treatment for prevention of cerebrovascular events in vulnerable patients. In this single-center multi surgeon study, we aimed to evaluate outcomes of neurologically stable patients who underwent CEA after symptoms of cerebrovascular?event according to time between the event and operation.?Methods:?In our clinic during 2008-2012,?we applied 67 CEA to 65 patients. Ten of these 65 patients excluded from trial due to combined CABG operation. 18 patients were asymptomatic prior to operation and excluded. Thirty-nine of these patients were symptomatic and enrolled to study. Data were collected retrospectively. All enrolled patients were divided into two groups, according to the time between event and operation. Group I: Early Group (≤14 days).?Group II: Late Group (>14 days). Results:?In our clinic during 2008-2012, we applied 39 CEA procedures to consecutive 37 patients with symptomatic carotid artery stenosis. None of preoperative variables were associated with postoperative mortality (p > 0.05). We observed postoperative bleeding in one patient who was in Late Group (II). Postoperative bleeding was only associated with hyperlipidemia (p = 0.003). Postoperative stroke was observed in moderate cardiac risk patients in Early Group (I) (p = 0.003). But none of the postoperative complications were associated with study groups. We observed that, closure technique (primary closure) was associated with postoperative stroke (p = 0.030). We have achieved shorter waiting time during study time phrase but it couldn’t reached statistical significance (p = 0.196).?Conclusion:?Although symptomatic patients have a higher risk of perioperative complications compared with asymptomatic patients, early CEA after symptom onset does not influence the results. This raises the question of the optimal timing of Carotid Artery intervention in symptomatic carotid artery stenosis. To answer this question, more data are needed preferably from lar

关键词： Cerebrovascular Event Carotid Artery Stenosis Endarterectomy

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Nearly Total Obstruction of Ascending Aorta by Intimal Flap in Tip 1 Aortic Dissection

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Surgical Science 2013年第1期4卷 114-117页

作者： Okay Güven karaca Ayse Gül Kunt mehmet Kalender mehmet Tasar Ata Niyazi Ecevit Osman Tansel Darcin Cardiovascular Clinics Konya Education and Research HospitalKonyaTurkey

Acute Type I aortic dissections are fast progressing highly mortal vascular emergencies if management delays. In this particular paper we report a case with a Type I aortic dissection mistreated for first 2 hours as thrombotic AMI, and aortic dissection diagnosis confirmed and treated surgically immediately. 59 years old male patient admitted to emergency room with sudden onset chest pain. Patient was seen by cardiologist and with NSTMI diagnosis admitted to Coronary ICU. With the suspicion of aortic dissection patient was scanned with contrasted thoraco-abdominal CT. Exam revealed subtotal occlusion of ascending aorta by flap of De Bakey Type I aortic dissection. In conclusion aortic dissection should be considered in differential diagnosis of chest pain. Clinical suspicion aortic dissection is key point of diagnosis and immediate confirmation may be life saving.

关键词： Acute Aortic Dissection

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眼睑皮肤松垂程度与年龄的关系——三级转诊中心的前瞻性研究（英文）

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国际眼科杂志 2016年第1期16卷 19-23页

作者： Feride Aylin Kantarci Muhammed Nabi Kantarci mehmet Gurkan Tatar Emine Esra karaca 法提赫大学医学院眼科土耳其伊斯坦布尔马尔泰佩34844 法医科学研究所司法行政部法医学系土耳其伊斯坦布尔Bahcelievler34196 索尔贡州立医院眼科土耳其约兹加特索尔贡66700

目的:调查眼睑皮肤松垂的位置和程度及是否伴随假性上睑下垂与年龄的关系。方法:选取113例眼睑皮肤松垂患者纳入本研究,记录患者的年龄,性别及体质指数。于第一眼位检测睑裂高度和睑缘至瞳孔反射点距离(MRD)。皮肤松垂的程度分为1级:皮... 详细信息

目的:调查眼睑皮肤松垂的位置和程度及是否伴随假性上睑下垂与年龄的关系。方法:选取113例眼睑皮肤松垂患者纳入本研究,记录患者的年龄,性别及体质指数。于第一眼位检测睑裂高度和睑缘至瞳孔反射点距离(MRD)。皮肤松垂的程度分为1级:皮肤松垂未及睑缘(至少距睑缘1 mm);2级:皮肤松垂达睑缘水平;3级:皮肤松垂越过睑缘前。结果:患者平均年龄为52.7±8.6(32~74)a。男36例(31.9%),女77例(68.1%)。平均体质指数为30.3±4.7(21.5~36.6)kg/m^2,平均睑裂高度为10.7+1.6(7~15)mm,平均MRD为3.8±1.2(1~5)mm。30例(26.5%)患者的皮肤松垂未及睑缘(1级)38例(33.6%)患者位于睑缘水平线(2级),而45例(39.8%)患者越过睑缘前(3级)。50例(44.2%)患者由于皮肤松垂引起假性上睑下垂。皮肤松垂程度在年龄方面的差异显著。皮肤松垂1级和2级患者的平均年龄(50.3±6.6,50.5±9.5岁)明显低于3级患者年龄(56.0±8.2岁)。假性上睑下垂患者(56.3±8.3岁)的平均年龄明显高于非假性上睑下垂患者(49.8±7.8岁)。对于皮肤松垂严重程度和假性上睑下垂患者体质指数无显著差别。结论:皮肤松垂严重程度和假性上睑下垂的发生率随年龄的增长而有所增加。

关键词：年龄上睑下垂眼睑皮肤松垂

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Neutralization versus Compression Plate on Lateral Malleolus Fracture:Is Lag Screw Necessary?

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Open Journal of Orthopedics 2019年第4期9卷 81-88页

作者： Ahmet Oztermeli Sinan karaca Firat Fidan Ozgun Karakus Department of Orthopaedics and Traumatology Gebze Fatih HospitalKocaeliTurkey Department of Orthopaedics and Traumatology Sancaktepe Ilhan Varank Training and Research HospitalIstanbulTurkey Department of Orthopaedics and Traumatology Omer Halis Demir University HospitalNigdeTurkey

Introduction: Our aim was to compare clinical and radiological results of lateral malleolus fracture treated with neutralization and compression plate. Material and Methods: 54 patients with isolated lateral malleolus fractures treated between March 2012 and April 2015 at Fatih Sultan mehmet Training and Research Hospital were evaluated with the Ankle-Hindfoot Scale of the American Orthopedic Foot and Ankle Society (AOFAS) score (excellent, ≥90;good, 75 - 89;acceptable, 50 - 74;poor, Results: There was no significant change in AOFAS, VAS, PSS and the union rates between two plating techniques. Conclusion: Similar results have shown both of two plating techniques were successful treating isolated lateral malleolus fracture.

关键词： Lateral Malleol Fracture Ankle Fracture Lag Screw Plate Fixation

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