KORONER ARTER HASTALIĞININ BELİRLEYİCISI OLARAK PENIL DOPPLER ULTRASONOGRAFİ İLE SAPTANAN KAVERNOZ ARTER STENOZU: OLGU SUNUMU

An association between Coronary Artery Disease (CAD) and Erectile Dysfunction (ED) has been described. We aimed to show that cavernous artery stenosis may be an important predictor of a silent but serious CAD. A 56-year-old man who had moderate ED was evaluated for risk factors. He had several vascular risk factors for ED and CAD including age, smoking, hypertension, hyperhomocysteinemia and hyperlipidemia. His penile colour Doppler ultrasonography revealed multiple stenotic area in the right cavernous artery. His treadmill exercise test showed significant changes. Then, coronary angiography was performed and it showed the patient had doublevessel CAD. Findings of atherosclerotic plaques in cavernosal arteries with penile Doppler ultrasonography may be address subclinical coronary artery stenosis in patients with ED. Koroner arter hastalığı ile erektil disfonksiyon arasındaki ilişki belirgindir. Bu yazıda kavernozal arter darlığının sessiz fakat ciddi koroner arter hastalığını gösterebileceğinin ortaya konulması amaçlandı. Orta şiddette erektil disfonksiyon yakınması olan 56 yaşındaki hasta risk faktörleri açısından değerlendirildi. Hastanın yaş, sigara, hipertansiyon, hiperhomosisteinemi ve hiperlipidemi olmak üzere çok sayıda vasküler risk faktörü vardı. Penil Doppler ultrasonografide sağ kavernozal arterde çok sayıda darlık saptandı. Treadmill egzersiz testinde belirgin değişiklikleri olan hastanın yapılan koroner anjiografisinde iki damarda stenoz saptandı. Erektil disfonksiyonlu hastalarda penil Doppler ultrasonografi ile kavernozal arterlerde saptanan aterosklerotik plaklar subklinik koroner arter hastalığı habercisi olabilir

C-REACTIVE PROTEIN LEVELS IN OBSTRUCTIVE SLEEP APNEA PATIENTS

Amaç: Obstrüktif Uyku Apne Sendromu (OUAS)'u olan hastalarda C-Reaktif Protein (CRP)'in erken ateroskleozun saptanmasında kullanılması. Yöntemler: Çalışmaya Dokuz Eylül Üniversitesi Tıp Fakültesi uyku bozukluğu polikliniğine başvuran, yaşları 20-66 arasında olan toplam 45 obez hasta alındı. Hastaların cinsiyet, yaş, boy, kilo değerleri saptandı. Vücut kitle indeksleri, bel / kalça oranları hesaplandı. Polisomnografi tetkiki yapıldı. OUAS'u olan hasta grubu ve OUAS'u olmayan kontrol grubu olarak iki gruba ayrıldı. Her iki grup hastadan açlık venöz kan örneği alınarak yüksek duyarlılıklı CRP düzeyleri ve lipid profilleri çalışıldı. B-mode dopler ultrasonografiyle karotis intima madia kalınlıkları ölçüldü. Bulgular: Kontrol grubunda yd-CRP düzeyleri 0,22 (0,01-0,57) mg/dl, OUAS'lı hasta grubundaysa 0,30 (0,05-1,52) mg/dl olarak bulundu, iki grup arasında istatiksel olarak anlamlı fark saptanmadı (p=0,300). Karotis İntima Media Kalınlığı (KİMK) ölçümleri değerlendirildiğinde her iki grup arasında istatistiksel olarak anlamlı fark saptandı (p=0,01). Bel / kalça oranları belirlenip, abdominal obezite açısından değerlendirildiğinde iki grup arasında istatistiksel olarak anlamlı fark gözlendi (p<0,01). AKŞ, TK ve LDL-K düzeylerinde de anlamlı fark saptandı (p=0,049, p=0,01 ve p=0,03). Sonuç: OUAS'lı hastalarda abdominal obezite, AKŞ, TK ve LDL-K düzeylerinde istatistiksel olarak anlamlı fark saptanması OUAS metabolik sendrom ilişkisi için varolan kanıtları doğruladı. Bununla birlikte, ölçülen CRP düzeylerinin OUAS'u hastalarında erken aterosklerozun gösterilmesinde iyi bir gösterge olmayabileceği belirlendi. Objective: To determine whether CRP can detect subclinic atherosclerosis in obstructive sleep apnea patients. Methods: Ages between 20-66, 45 obese patient who was have application to D.E.Ü. Medical Faculty sleep laboratory recruited to study. We determine sex, age, height and weight for all patients and calculate body mass index, waist / hip raito. Polisomnographia was done. Patient's divided in to two group's, whose PSG detected OSA constitute patients group and whose PSG not detected OSA constitude control group. We obtained fasting venous blood sample and measure HSCRP and lipid profiles. Carotis intima media thickness measured with B-mode doppler ultrasonography. Results: HSCRP found 0,22 (0,01-0,57) mg/dl in control group and 0,30 (0,05-1,52) mg/dl in OSA patients group, we didn't detect statistical significancy (p=0,300). When Carotid İntima Media Thickness (CIMT) measurements evaluated for each group, statistical significancy find (p=0,01). WHR determined and evaluated for abdominal obesity, statistical significancy found between two group (p<0,01). Also significant differece detected for FBG, TK and LDL-K (p=0,049, p=0,01 and p=0,03). Conclusion: Detected significant difference for abdominal obesity, FBG, TK and LDL-K levels in OSA patients confirmed existing evidence of relation eith sleep apnea and metabolic syndrome. Although we determined, measured HSCRP levels may not be a good marker for presenting subclinic atherosclerosis in OSA patients

Levels of paraoxonase and arylesterase activities and malondialdehyde in workers exposed to ionizing radiation

We examined levels of malondialdehyde (MDA) (an end-product of lipid peroxidation) and paraoxonase (PON1) (an antioxidant enzyme) activity and PON1 phenotypes in people who were exposed to ionizing radiation for different time periods and doses. A total of 78 individuals (mean age 34 7 years) were included in the study. Fifty-one of them were radiology workers whereas the control group was composed of 27 healthy volunteers who had never worked in a radiology-related job. Paraoxon was used as substrate for measurement of PON1 activity levels (basal and NaCl-stimulated). Phenylacetate was used as substrate for measurement of arylesterase activity levels. Cumulative levels of serum NaCl-stimulated PON1/arylesterase activities were utilized for phenotypic differentiation. In radiology workers, three different phenotypes were determined based on paraoxonase/arylesterase ratio. The ratios were 1.09 +/- 0.30 for AA (homozygote low activity); 2.91 +/- 1.07 for AB (heterozygote activity) and 4.97 +/- 1.21 for BB (homozygote high activity). There was a statistically meaningful negative correlation between serum MDA levels and PON1 activity levels in all phenotypes (p 5 years) radiation compared to controls. There was no statistically significant correlation between serum arylesterase activity and MDA levels in these subjects (r = -0.185, p > 0.05). PON1 activity levels were decreased whereas serum MDA levels were increased in individuals exposed to radiation for a long period. PON phenotypes of people employed in jobs which expose them to radiation should be determined and based on these findings they should be advised to avoid risk factors inducing oxidative stress, such as smoking, and to consume foods rich in vitamins and trace elements to increase their antioxidant capacity. Copyright (C) 2003 John Wiley Sons, Ltd.We examined levels of malondialdehyde (MDA) (an end-product of lipid peroxidation) and paraoxonase (PON1) (an antioxidant enzyme) activity and PON1 phenotypes in people who were exposed to ionizing radiation for different time periods and doses. A total of 78 individuals (mean age 34 +/- 7 years) were included in the study. Fifty-one of them were radiology workers whereas the control group was composed of 27 healthy volunteers who had never worked in a radiology-related job. Paraoxon was used as substrate for measurement of PON1 activity levels (basal and NaCl-stimulated). Phenylacetate was used as substrate for measurement of arylesterase activity levels. Cumulative levels of serum NaCl-stimulated PON1/arylesterase activities were utilized for phenotypic differentiation. In radiology workers, three different phenotypes were determined based on paraoxonase/arylesterase ratio. The ratios were 1.09 +/- 0.30 for AA (homozygote low activity); 2.91 +/- 1.07 for AB (heterozygote activity) and 4.97 +/- 1.21 for BB (homozygote high activity). There was a statistically meaningful negative correlation between serum MDA levels and PON1 activity levels in all phenotypes (p &lt; 0.05). PON1 activity levels were found to be 25-35% lower in people who were exposed to long-term ( &gt; 5 years) radiation compared to controls. There was no statistically significant correlation between serum arylesterase activity and MDA levels in these subjects (r = -0.185, p &gt; 0.05). PON1 activity levels were decreased whereas serum MDA levels were increased in individuals exposed to radiation for a long period. PON phenotypes of people employed in jobs which expose them to radiation should be determined and based on these findings they should be advised to avoid risk factors inducing oxidative stress, such as smoking, and to consume foods rich in vitamins and trace elements to increase their antioxidant capacity.</p

Use of Percutaneous Aspiration Thrombectomy vs. Anticoagulation Therapy to Treat Acute Iliofemoral Venous Thrombosis: 1-year Follow-up Results of a Randomised, Clinical Trial

The purpose of this study was to compare the efficacy of percutaneous aspiration thrombectomy (PAT) followed by standard anticoagulant therapy, with anticoagulation therapy alone, for the treatment of acute proximal lower extremity deep vein thrombosis