Obstrüktif uyku apne sendromu semptom ve bulguları ile obezite arasındaki ilişki

Amaç: Bu çalışmanın amacı obezitenin obstüktif uyku apne sendromu (OUAS) üzerindeki etkilerini objektif ve subjektif veriler eşliğinde değerlendirmektir. Yöntem: Toplam 70 hasta obez (n=38; VKİ>35 kg/m2) ve obez olmayan (n=32; VKİ35 kg/m2) and non-obese patient groups (n=32; BMI<30 kg/m2). The Epworth sleepiness scale scores, modified Mallampati index scores, levels of obstruction in the oropharynx and soft palate, neck circumference and polysomnography findings between two groups were compared. Results: Obese patients had an average Mallampati score of Class III while the non-obese study participants had an average score of Class II, with a statistically significant intergroup difference. In Muller's maneuver, the levels of obstruction in both the soft palate and oropharynx were higher in the obese patients with a statistically significant difference between two groups. When polysomnography results were examined, the average apnea-hypopnea index (AHI) score was determined to be 22.5 in the obese and 6.4 in the non-obese groups, respectively. Furthermore, average scores of rapid eye movement (REM) AHI in the non-obese and obese patients were 4.6 and 17.2 with a statistically significant difference between the groups. The average lowest oxygen saturation was 75.5% in the obese and 88% in the non-obese group, which represented a statistically significant difference between groups. In the obese group, the number of patients with REM-dependent OSAS was higher than in the non-obese group which attained a level of statistical significance. Conclusion: Our study indicated that obesity increases the severity of OSAS, in part due to significant narrowing of the airway at the level of the soft palate and oropharynx. Additionally, our study has shown that the risk of supine position-dependent OSAS and especially REM-dependent OSAS were notably higher in obese patients

A Rare Cause of Pheochromocytoma; Neurofibromatosis Type 1-Noonan Syndrome

Neurofibromatosis (NF) Type 1 (NF-1) is an autosomal dominant disease with a prevalence of about 1/3000. NF-1 is a neurocutaneous syndrome characterized by cafe au lait macules, neurofibroma, optic glioma, lisch nodules, and symptoms involving other systems. Noonan syndrome (NS) is a clinically heterogeneous disorder predominantly characterized by dysmorphic facial features, congenital heart disease, proportionate post-natal short stature, neck abnormalities, and chest deformities. NF-NS is a very rare overlapping syndrome sharing many features of both syndromes. Coexistence of pheochromocytoma, which can be life-threatening if not treated properly, is also a very rare complication of this disorder. Here, we report a patient who was admitted with a mass in the right upper quadrant and was diagnosed with pheochromocytoma and NFNS. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 227-31

A Case Report of Insulinoma Located with Calcium Stimulation Test

Although rarely seen, insulinomas are the most common neuroendocrine tumors of the pancreas. It can be life threatening due to hypoglisemia. Diagnosis is base on clinical and laboratory findings. Radiological findings are helpful to confirm the diagnosis and to determine surgical procedure. If no tumor found by radiological investigations, selective arterial calcium stimulation test can be performed for the diagnosis and localization. Here, we report a case of insulinoma which truly located only with the calsium stimulation test, and operated successfully