Obstrüktif uyku apnesi tan›s›nda periferik arteriyel tonometrinin de¤erlendirilmesi

Objective:Peripheral arterial tonometry (PAT) as a portable method of monitoring sleep quality is a relatively recent innovation. The aim was to compare the results of PAT and polysomnography (PSG) and to evaluate the role of PAT in diagnosing obstructive sleep apnea syndrome (OSAS). Methods: This study included adult patients who admitted to ENT clinic with OSAS complaints (excessive daytime sleepiness, snoring, and witnessed apnea), undergone sleep monitorization using PAT system (WatchPAT 200TM; Itamar Medical Ltd., Caesarea, Israel) and had single-blind, level 1 polysomnography at sleep laboratory of Chest Diseases Department. Results: For the two sleep monitoring sessions as conducted at different times: the apnea-hypopnea index (AHI) and respiratory disturbance index (RDI) values were strongly correlated between sessions (r=0.749, r=0.753; p<0.001). The oxygen desaturation index (ODI) values were very strongly correlated (r=0.861; p<0.001). When the AHI scores calculated using PAT for the patients enrolled in the trial were taken into consideration; 89.7% of the patients were correctly diagnosed with OSAS (AHI?5); for RDI calculated (RDI?5) using PAT, 100% of OSAS diagnoses were correct; for AHI values calculated with the PAT method, taking 15 as cut-off point, the sensitivity was found to be at an extremely high level of 96.1%. Conclusion: PAT and PSG values were highly correlated. This finding demonstrated that the reproducibility of the results obtained with PAT was also high. This study shows that PAT can be used as a screening test for OSAS and in a group of patients who are highly suspected for OSAS.Amaç: Periferik arteriyel tonometrinin (PAT), uyku monitörizasyonunda ta?›nabilir bir yöntem olarak kullan›m› k›smen yeni bir yöntemdir. Bu çal›?mada, PAT sonuçlar› ile polisomnografi (PSG) sonuçlar›n›n kar?›la?t›r›lmas› ve obstrüktif uyku apnesi sendromu tan›s›nda PAT’›n rolününün de¤erlendirilmesi amaçland›. Yöntem: Bu çal›?maya KBB klini¤ine OSAS ?ikayetleri (gündüz uykululuk hali, horlama ve tan›kl› apne) ile ba?vurmu? ve uyku monitörizasyonu PAT sistemi (WatchPAT 200TM; Itamar Medical Ltd., Caesarea, ‹srail) ile yap›lm›?, daha sonra Gö¤üs Hastal›klar› Uyku Laboratuvar›nda kör olarak level 1 polisomnografi uygulanm›? eri?kin hastalar dahil edildi. Bulgular: ‹ki farkl› zamanda yap›lm›? uyku monitörizasyonunda apne hipopne indeksi (AHI) ve solunum bozuklu¤u indeksi (RDI) de¤erleri yüksek oranda korele idi (r=0.749, r=0.753; p<0.001). Oksijen desatürasyon indeksi (ODI) de¤eri ise çok yüksek oranda korele saptand› (r=0.861; p<0.001). Çal›?maya dahil edilen hastalar›n AHI skorlar› PAT yöntemiyle ölçüldü¤ünde; hastalar›n %89.7’si OSAS için (AHI?5) do¤ru tan› ald›; PAT testinde, RDI’ye göre yap›lan de¤erlendirmede (RDI?5) OSAS tan›lar›n›n %100’ü do¤ru idi; PAT yöntemiyle yap›lan ölçümde AHI de¤eri için e?ik de¤eri 15 olarak kabul edildi¤inde, duyarl›l›k %96.1 olarak oldukça yüksek bulundu. Sonuç: PAT ve PSG de¤erleri yüksek oranda korele idi. Bu durum PAT ile elde edilen sonuçlar›n tekrarlanabilirli¤inin de yüksek oldu¤unu göstermi?tir. Çal›?mam›z PAT’›n OSAS’da tarama testi olarak ve yüksek oranda OSAS ?üphesi olan hasta grubunda kullan›labilece¤ini göstermektedir

Integration of metabolome data with metabolic networks reveals reporter reactions

Interpreting quantitative metabolome data is a difficult task owing to the high connectivity in metabolic networks and inherent interdependency between enzymatic regulation, metabolite levels and fluxes. Here we present a hypothesis-driven algorithm for the integration of such data with metabolic network topology. The algorithm thus enables identification of reporter reactions, which are reactions where there are significant coordinated changes in the level of surrounding metabolites following environmental/genetic perturbations. Applicability of the algorithm is demonstrated by using data from Saccharomyces cerevisiae. The algorithm includes preprocessing of a genome-scale yeast model such that the fraction of measured metabolites within the model is enhanced, and thus it is possible to map significant alterations associated with a perturbation even though a small fraction of the complete metabolome is measured. By combining the results with transcriptome data, we further show that it is possible to infer whether the reactions are hierarchically or metabolically regulated. Hereby, the reported approach represents an attempt to map different layers of regulation within metabolic networks through combination of metabolome and transcriptome data

Dynamic thiol/disulphide balance in patients undergoing hypotensive anesthesia in elective septoplasties

Objective We aimed to investigate the effects of hypotensive anaesthesia on oxidative stress with serum thiol/disulphide balance in patients undergoing elective septoplasty procedures under general anaesthesia. Methods Seventy-two patients between the ages of 18-60, with a physical condition I -II, according to the American Society of Anesthesiologists, were included in this prospective observational study. Septoplasty was chosen for standard surgical stress. According to the maintenance of anaesthesia, patients were divided into the groups as Hypotensive Anaesthesia (n = 40) and Normotensive Anaesthesia (n = 32). Serum thiol/disulphide levels were measured by the method developed by Erel & Neselioglu. Results The native thiol and total thiol values of both groups measured at the 60th min intraoperatively were significantly lower than the preoperative values (both P 40 years and female gender were found to have a significant effect on dynamic oxidative stress (P = .002 and .001, respectively). Conclusion This pilot study has found that hypotensive anaesthesia had no adverse effect on dynamic thiol/disulphide balance in elective surgeries

Contralateral suppression of otoacoustic emissions in migraine patients without vestibular involvement

Özet: Vestibüler flikayeti olmayan migren hastalar›nda kontralateral otoakustik emisyon süpresyonu Amaç: Bu çal›flman›n amac› duyusal modülasyon bozuklu¤una yol açan migren hastal›¤› olan kiflilerde iflitme sistemi refleksi ölçümünde kullan›lan bir test olan kontralateral otoakustik süpresyon testinin sonuçlar›n›n de¤erlendirilmesidir. Yöntem: Çal›flmaya nöroloji poliklini¤ine baflvuran, Uluslararas› Bafla¤r›s› Derne¤i&apos;nin 2004 y›l› kriterlerine göre migren tan›s› alan ve vestibüler flikayeti olmayan gönüllü migren hastalar› ve sa¤l›kl› gönül-lüler dahil edildi. Bütün gönüllülere tam otolojik muayene, saf ses odyometri testi yap›ld›. Bilateral otoakustik emisyon yan›t› al›nan 30 gö-nüllü migren hastas› ve karfl›laflt›rma için yafl ve cinsiyet özellikleri gö-nüllü hasta grubuna benzeyen 30 sa¤l›kl› gönüllü çal›flmaya dahil edildi. Çal›flmaya dahil edilen gönüllülere kontralateral 50 dB SPL genifl bant gürültü ile maske yap›larak 65 dB click uyaran ile maskeli ve maskesiz otoakustik emisyon ölçümleri yap›ld›. Her iki gruptan elde edilen veriler karfl›laflt›r›ld›. Bulgular: Sa¤l›kl› gönüllülerin de¤erlendirilen 60 kula¤›n›n 40&apos;›nda (%67) süpresyon testi pozitif olarak tespit edilirken migren hastalar›n›n de¤erlendirilen 60 kula¤›ndan 30&apos;unda (%50) süpresyon testi pozitif olarak tespit edildi. Fakat süpresyon pozitifli¤i oranlar›nda ve süpres-yon emisyon de¤erlerinde istatistiksel olarak anlaml› bir fark izlenmedi. ‹ki grup aras›nda istatistiksel olarak anlaml› bir fark olmasa da migrenli grupta kontralateral supresyon cevaplar›nda azalma izlendi. Sonuç: Vestibüler flikayeti olmayan migren hastalar›nda normal kiflilerle karfl›laflt›r›ld›¤›nda istatistiksel olarak anlaml› olmasa da kontralateral süpresyon cevaplar›nda bir azalma izlenmektedir. Daha büyük seri içeren yeni çal›flmalar ile kontralateral otoakustik emisyon testi vestibüler flikayeti olmayan migren hastalar›nda odyovestibüler flikayetlerin erken tan›s›nda kullanabilece¤i kanaatindeyiz. Anahtar sözcükler: Kontralateral süpresyon testi, MOC refleksi, non-vestibüler migren, otoakustik emisyon. Abstract Objective: Our aim was to investigate contralateral suppression of otoacoustic emission for the evaluation of auditory reflex in patients with migraine which is a disease that may cause dysfunction of sensorial modulation. Methods: Voluntary migraine patients without vestibular symptoms who consulted to Neurology Clinic, and diagnosed according to the IHS 2004 criteria, and healthy volunteers were included in the study. All volunteers underwent complete otorhinolaryngologic and puretone audiometric examinations. Thirty voluntary migraine patients with bilateral otoacoustic emission measurements, and 30 healthy volunteers matched in terms of age and sex were included in the study. Otoacoustic emission measurements were obtained with 65 dB SPL click stimulus with and without mask by masking with contralateral 50 dB SPL broad band noise. Responses were compared between two groups. Results: Positive result was obtained in suppression tests in 40 of 60 (67%) ears of healthy volunteers and in 30 of 60 (50%) ears of migraine patients. However, there was no statistically significant difference between groups regarding positive suppression frequency and suppression values. Even though a statistically significant difference between migraine patients without vestibular involvement and control group was not seen, there was a decrease in contralateral suppression responses in the migraine group. Conclusion: Although it is statistically insignificant, we have demonstrated that migraine patients without vestibular symptoms showed a decrease in the suppression values compared to the healthy volunteers. We believe that in new studies with larger series, contralateral otoacoustic emission suppression test can be used as an early tool to diagnose audiovestibular symptoms in migraine patients without any vestibular involvement

A Comparison of right ventricular hemodynamic parameters pre and postoperatively of patients with isolated mitral stenosis who undergone mechanical valve replacement

Bu çalışmada izole mitral darlıklı hastalarda sağ ventrikül fonksiyonlarının önemi ve kapak replasmanının yol açtığı hemodinamik düzelme araştırıldı. Ocak 1991 - Temmuz 1995 dönemleri arasında Selçuk Üniversitesi Tıp Fakültesi Göğüs Kalp ve Damar Cerrahisi kliniğinde MVR uygulanan izole fıbrokalsifık mitral stenozlu 20 hastada hemodinamik parametreler preoperatif ve erken postoperatif dönemde değerlendirildi. MVR uygulanan hastalarda bozulmuş RV fonksiyonlarının düzeldiği, bu durumun hastanın semptomları ve yaşam beklentisi ile uyumlu olduğu gösterildi. Replasman uygulanması gereken hastalarda optimal zamanlama için RVEF ya da bununla ileri derecede koralasyon gösteren PVR'ın değerlendirilmesinin önemi vurgulandı.A COMPARISON OF RIGHT VENTRICULAR HEMODYNAMIC PARAMETERS PRE AND POSTOPERATIVELY OF PATIENTS WITH ISOLATED MITRAL STENOSIS WHO UNDERGONE MECHANICAL VALVE REPLACEMENT In this study, importance of the right ventricular functions of patients with mitral stenosis and how the valve replacement improves right heart hemodynamics were searched. Hemodynamic parameters were measured pre and postoperatively in 20 patients with isolated fibrocalcific mitral stenosis who undergone mitral valve replacement in the Thoracic and Cardiovascular Surgery of the Faculty of Medicine University of Selçuk between January 1991 and July 1995. It was demonstrated that valve replacement improves impaired right heart functions which is closely related to prognosis. It is suggested that in patients who require valve replacement RVEF- or PVR that highly correlated with RVEF- should be used as a main prognostic factor

Üsküdar - Bostancıbaşı Derbendi güzergâhı mimari eserlerinin kitabeleri

Donated by Klaus KreiserReprinted from in : Tarih dergisi, Cilt: 9, sayı. 13, 1958

Rumeli Kadıları'nda 1078 düzenlemesi

Donated by Klaus KreiserReprinted from in : İsmail hakkı Uzunçarşıl'ya Armağan : Türk Tarih Kurumu Yayınları, Dizi: VII, Sayı: 70 = Türk tarih Kurumu Basımevi, 1976

Evliya Çelebi Seyâhat-Namesi

Donated by Klaus KreiserReprinted from in : Hisar, 1971

Türk resim tarihinin yazılı kaynakları:Evliya Çelebi Seyahat-namesi (II)

Taha Toros Arşivi, Dosya No: 179-Evliya Çelebiİstanbul Kalkınma Ajansı (TR10/14/YEN/0033) İstanbul Development Agency (TR10/14/YEN/0033