Baş düşmesi ile prezente olan motor nöron hastalığı

Motor nöron hastalığı, yutma, yürüme, konuşma ve nefes alma gibi işlevlerden sorumlu olan istemli kasları innerve eden motor nöronların tutulumu ile karakterize progresif nörolojik bir hastalıktır. En sık görülen formu amyotrofik lateral sklerozdur. Nörolojik muayene bulguları üst ve alt motor nöron dejenerasyonunu gösterir. Hastalığın tanısı için spesifik bir biyolojik marker bulunmamaktadır. Klinik özellikler elektromiyografik bulgularla birleştirilerek tanı konur. Literatürde az sayıda atipik prezentasyonlu motor nöron hastalığı olgusu bulunmaktadır. Bu yazıda boyun kaslarında progresif güçsüzlükle başlayan atipik bir motor nöron olgusu sunulmuştur.Motor neuron diseases are a group of progressive neurological disorders that destroy motor neurons that control voluntary muscle activity such as swallowing, walking, speaking and breathing. The common form of motor neuron disease is amyotrophic lateral sclerosis. Neurological examination presents specific signs associated with upper and lower motor neuron degeneration. In the absence of any biological marker, the diagnosis of motor neuron disease is based on clinical features, combined with the results of electromyography. Some patients of motor neuron disease with atypical presentation have been reported in the literature. We presented here a case of motor neuron disease with atypical presentation who had progressive weakness of the neck muscles

Hepatic encephalopathy and atypical cortical involvement in cranial MRI: Case report

Hepatik ensefalopati karaciğer fonksiyon bozukluğuna bağlı olarak hastalarda nöropsikiyatrik belirtilerin gelişimi ile karakterizedir. Siroz, portal hipertansiyon veya porto-sistemik şantlar ve akut karaciğer yetmezliği durumlarında gelişebilir. Hafif mental durum bozukluklarından derin komaya kadar değişen geniş bir klinik tablo ile ortaya çıkabilir. Manyetik rezonans görüntüleme (MRG) başta olmak üzere nöro-görüntüleme teknikleri hepatik ensefalopati tanısında kullanılabilir. Sağlıklı bireylerde kolayca metabolize edilebilen maddelerin birikimine bağlı olarak özellikle T1 ağırlıklı MRG'de iki yanlı globus pallidus yapılarında sinyal artışı izlenir. Hepatik ensefalopatide kortikal tutulum oldukça nadir bildirilmiştir. Bu yazıda kortikal ve subkortikal yapıların tutulumu ile seyreden bir hepatik ensefalopati olgusu sunulmuştur.Hepatic encephalopathy is characterized by neuropsychiatric abnormalities occurring in patients with liver dysfunction. It most commonly occurs in association with cirrhosis, portal hypertension, portal-systemic shunts and acute liver failure. Clinical features of hepatic encephalopathy varies between mild cognitive impairment to deep coma. Several neuroimaging techniques, especially magnetic resonance imaging (MRI), may eventually be useful for the diagnosis of hepatic encephalopathy. Cranial MRI may demonstrate high signal intensity in the bilateral globus pallidum on T1-weighted images. Cortical involvement due to hepatic encephalopathy is rarely reported in the literature. We presented here a case of hepatic encephalopathy with cortical and subcortical involvement

Performance optimization of JPEG 2000 decompression for ground observation satellite operations

Yüksek sıkıştırma performansı, bit hatalarına karşı dayanımı ve kayıpsız modun yanısıra esnek kayıplı modları desteklemesi nedeniyle JPEG 2000, uydu görüntü işleme, uzaktan algılama ve diğer birçok alanda sıklıkla kullanılan bir görüntü sıkıştırma standardıdır. Kamera ve haberleşme teknolojisinin gelişmesiyle birlikte yer gözlem uydu görüntülerinin çözünürlükleri ve indirme hızları gün geçtikçe artmaktadır. Dolayısıyla JPEG 2000 kod çözme dahil olmak üzere, uydu operasyonu dahilindeki tüm görüntü işleme aşamalarının eş zamanlı olarak hızlandırılması büyük önem arz etmektedir. Literatürde JPEG 2000 kod çözme işleminin GPU'da hızlandırılmasına dair, yer gözlem uydu operasyonlarına doğrudan uyarlanabilecek çalışmalar yetersiz kalmaktadır. Bu çalışmada, öncelikli olarak JPEG 2000 kod çözücünün GPU'da CUDA optimizasyon yöntemleriyle hızlandırılması konu alınmıştır. Buna ek olarak, GPU ve CPU işlemcilerin birlikte tam verimlilikte kullanıldığı bir hibrit kod çözücü tasarımı önerilmiştir. Son olarak, homojen düğümlerden oluşan, esnek ve ölçeklenebilir bir dağıtık JPEG 2000 kod çözücü mimarisi tasarlanmıştır. Bu çalışmanın, uydu görüntü işleme sürecindeki diğer aşamaların hızlandırılmasına yönelik gelecek çalışmalar için faydalı bir referans ve perspektif kazandıracağı öngörülmektedir.Due to its high compression performance, bit-error resilience, and support for both lossly and flexible lossy modes, JPEG 2000 is an image compression standard which is widely used in satellite image processing, remote sensing and many other fields. With the recent advancements in camera and telecommunication technology, resolution and download rate of ground observation satellite imagery are continually increasing. This makes it crucially important to simultaneously speed-up all image processing stages in satellite operations, including JPEG 2000 decompression. Existing work in literature regarding the optimization of JPEG 2000 for GPU is insufficient in terms of applicability to ground observation satellite operations. This work primarily focuses on speeding-up the JPEG 2000 decoder for GPU using CUDA optimization techniques. Also a hybrid decoder has been proposed which involves utilization of CPU and GPU together at maximum efficiency. Lastly, a distributed homogeneous JPEG 2000 decoder architecture has been proposed which is highly flexible and scalable. This work is anticipated to provide a useful reference and perspective to future studies regarding the speed-up of other stages in satellite image processing

Kendini tanımlayan yer sistem modellerine doğru: Bir iş akışı uygulaması

The application of scientific workflow systems for orchestrating complex tasks is still an open research area. In particular, earth system related modeling applications consists of different tasks that are closely related to each other and scientific workflow systems can be used to simplify these sub processes and their relationships. The motivation for this work is driven by the complexities of running a large modeling system on a high performance computing and network systems and need to reduce those complexities, particularly for the average user.In this study, it is presented and analyzed a new methodology to combine scientific workflow system and modeling framework approach together to create standardized work environment. Then, the proposed methodology is tested using a typical and realistic earth system modeling application. The result of example workflows that are based on the proposed methodology is a part of this study.A Modeling framework is a standardized programming environment for combining model components and couplers of different kinds of earth system models using a common calling interface. Earth System Modeling Framework (ESMF) is one of the most popular examples for this approach. It consists of a superstructure for coupling components of Earth system applications and an infrastructure of robust, high-performance utilities and data structures that ensures consistent component behavior. Extending beyond the modeling framework approach, scientific workflow systems create standardized interfaces to a variety of technologies and automate the execution and monitoring of a heterogeneous workflow. Namely, a scientific workflow system is a problem-solving environment that simplifies tasks by creating meaningful and easy understandable sub-tasks and combining them to form executable data management and analysis pipelines. Kepler was chosen as the workflow environment for this work because it is open source, platform independent, and it supports different models of computation such as Process Network (PN) and Synchronous Data Flow (SDF). Kepler is a scientific workflow system that is based on the Ptolemy II project. The actor-oriented design of Kepler enables users to create hierarchically structured scientific workflows. The overall execution of model is controlled by separate component that is called a director (a special actor). Kepler supports different model of computation types via its directors.In application example, a regional coupled climate modeling system is developed for Mediterranean region and integrated into workflow system to provide better representation of regional climate system. This application has crucial importance in downscaling output of the global circulation models over Turkey and near regions. It also can be used to create better representation of regional climate for the future scenarios. The workflow application also collects provenance information automatically from the coupled earth system modeling system to reproduce, compare and debug results. The coupled atmosphere-ocean modeling system is based on NCAR's Weather Research and Forecasting (WRF) and Regional Ocean Modeling System (ROMS) model. To couple atmosphere and ocean models the ESMF library is used. For the atmospheric component (WRF), the experimental ESMF-IO structure is used to create ESMF fields and states to share data between different model components. The WRF ESMF-IO is also modified to add field level metadata into coupling variables (heat and momentum fluxes) of atmospheric model. In ocean component (ROMS), the coupler code is written to control each model component and also the gridded component code is developed to run each earth system model via ESMF init, run and finalize methods. The gridded component level metadata is added into coupler to create prototype version of self-describing modeling system. The results show that the developed workflow environment is capable of running different earth system models on a different high performance computing resource with a meaningful abstraction. The proposed work environment acts as an abstraction layer and hides the detail of the used infrastructure and earth system model from user and it also collect standardized provenance information about both model and computing resource to represent the work environment as possible as it can. Keywords: Scientific workflow, model coupling, provenance information, Kepler, ESMF.Bilimsel iş akış sistemlerinin karmaşık bileşen ve süreçler içeren çalışmalarda kullanılması, günümüzde oldukça popüler bir araştırma alanıdır. Özellikle yer sistem bilimleri açısından bakıldığında, birbirlerine sıkı bir şekilde bağlı, birçok alt bileşen içeren yer sistem modellerine ait süreçlerin basitleştirilmesi ve modüler bir yapıya kavuşturularak standartlaştırması için, bilimsel iş akış sistemleri kullanılabilir. Bu çalışmanın asıl amaçlarından biri, karmaşık yer sistem modelleme uygulamalarının, yüksek başarımlı hesaplama sistemlerinde çalıştırılmasının gittikçe zorlaşması, kendi kendisini tanımlayan yer sistem modellerine ve varolan karmaşık modelleme sistemlerinin anlamlı bir şekilde soyutlaştırılarak ortalama bir kullanıcı seviyesine indirgenmesine duyulan ihtiyaçtır. Bu amaçla, literatürde sıkça kullanılan bilimsel iş akışı ve çerçeve yaklaşımlarının birleştirilerek standartlaştırılmış bir çalışma ortamının yaratılması için yeni bir metodoloji geliştirilmiştir. Önerilen metodolojinin sınanması amacıyla, gerçekçi bir yer sistem modelleme uygulaması kullanılmış ve sonuçları analiz edilmiştir. Bu amaçla geliştirilen uygulama örneği, çerçeve yaklaşımı kullanılarak birleştirilmiş bir atmosfer-okyanus model sisteminin, bölgesel iklim sistemini daha gerçekçi olarak modellemek amacıyla iş akış sistemine entegre edilmesi ve model bileşenlerinden köken bilgisinin otomatik olarak toplanması süreçlerini içermektedir. Sonuçlar iş akışı ortamına entegre edilen model sistemlerinin daha kolay kullanılabildiğini ve toplanan köken bilgisinin çalışmanın evrimini kayıt altına alması açısından son derece önemli olduğunu göstermektedir. Ayrıca modellerin kuple edilmesi için kullanılan çerçeve uygulaması (ESMF), her bir alt yer sistem modeli için standart bir arayüz tanımlayarak model kuple sürecini ve yönetimini kolaylaştırmaktadır. Anahtar Kelimeler: Bilimsel iş akışı, çerçeve yaklaşımı, köken bilgisi, Kepler, ESMF

Spontaneous Intracerebral Hemorrhage: Etiology and Yearly Prognostic Factors

OBJECTIVE: Objectıve: To assess the risk factors in patients with history of spontaneous intracerebral hematoma, to determine the effects of these risk factors on mortality and morbidity and recurrence rate during 12-month follow up period, to investigate the risk factors. METHODS: Materials and methods: 215 patients with spontaneous intracerebral hermorrhage treated between January 2008-June2010 in Trakya University Faculty of Medicine Neurology Department were included in this study. Patients who suffered from a stroke due to arteriovenous malformation, subarachnoid hemorrhage, epidural hematoma and subdural hematoma were excluded. RESULTS: Results: It was determined that male gender, age and hypertension are risk factors for intracerebral hemorrhage. However diabetes mellitus, smoking and alcohol usage are not. Due to the scarcity of patients using antiaggregant and anticoagulant medication its statistical relation to intracerebral hemorrhage was not possible to define. Age over 65, hypertension, presence of hyperglycemia at the time of admission, size of hematoma, presence of intraventricular hemorrhage and score calculated at the time of admission according to National Health Institute Stroke Scale are important factors for prognosis. The influence of age 5 and older was seen to be an independent risk factor, whereas presence of hypertension was analyzed to increase the recurrence rate. CONCLUSION: Dıscussıon: Knowledge on the risk factors of intracerebral hemorrhage is essential on taking preventive measures. Factors affectiong the prognosis on patients who underwent intracerebral hemorrhage must be recognized. This way morbidity rates may be reduced with the treatment of curable cases, thus releiving the economical burden from the health syste

Herpes Zoster Ophthalmicus With Sixth Cranial Nerve Palsy: A Case Report

Scientific BACKGROUND: Herpes zoster ophthalmicus represents aproximately 25% of all zoster infections. However extraocular gaze palsy in association with herpes zoster infection is extremely rare. OBJECTIVE: We presented here a patient who had herpes zoster ophthalmicus with sixth cranial nerve palsy. CASE: The sixty year old patient had suffered from left retroorbital pain, conjunctival congestion and rashes on the left forehead and the nose and developed ipsilateral sixth cranial nerve palsy. RESULT: Herpes zoster virus infection should be taken into consideration in patients with extraocular paralysis and early treatment may prevent such complication

Acute isoniazide intoxication. Case report

Akut isoniazid (INH) intoksikasyonu, epileptik nöbetler, koma ve metabolik asiden, triadı ile karakterime bir klinik tablodur. Özellikle yeterli öykü alınamadığı durumlarda, bu tablo ensefalit, meningoensefalit veya ensefalopati ile karışabilmektedir. Bu makalede ateş yüksekliği, bilinç kaybı ve status epileptikus tablosu ile prezante olan ve bu klinik bulguların etiolojisinde daha sonra INH intoksikasyonu saptanan, 19 yaşındaki olgu dolayısıyla, INH intoksikasyonun klinik ve laboratuvar bulguları ve ayırıcı tanı olasılıkları literatür bilgileri ışığında tartışılmıştır.Acute isoniazid (INH) intoxication is a clinicical case that is characterized by epileptic seizures, coma and metabolic asidosis triad. Especially in the conditions where sufficient history cannot be obtained, this case may be confused with encephalitis, meningoencephalitis or encephalopathy. In this article, the clinical and laboratory findings and the differential diagnosis probabilities of INH intoxication are discussed under the light of literature information because of a 19-year-old case who is presented with high fever, loss of conciousness and status epilepticus, in the ethiology of which INH intoxication was later detected

The Gray Zone in Thyroid Nodules: Atypia of Undetermined Signifi cance/ Follicular Lesion with Unknown Signifi cance

Major purpose of the management of thyroid nodules is to distinguish between malignant nodules and the benign ones. Nodules with the cytology result Atypia of Undetermined Significance or Follicular Lesion of Undetermined Significance are still a diagnostic challenge. Initial presentation of the Bethesda System was based on 7% diagnosing rate and around 5-15% malignancy rate for these nodules; however, clinical practice presents with higher rates for both variables. Recent studies showed that when these nodules are grouped by cytological features; compared with the architectural atypia group, the cytological atypia group has a significantly higher risk of malignancy. Cytological sub-classification, ultrasonographic evaluation and genetic tests in selected cases should be used in the management of these nodules.</p