MODELING THE PERFORMANCE OF PERSONALIZED VENTILATION UNDER DIFFERENT ROOM AIRFLOWS

Personalized ventilation (PV) has the ability to improve inhaled air quality and accommodate the individual thermal preference. In this paper one kind of personalized ventilation system which supplies fresh air at the microphone position is investigated numerically. A numerical thermal manikin with the real geometry of human body is used to study the airflows around the occupant equipped with PV. The performance of one RNG k-ε model and the standard k-ε model is compared. The benefits of PV under different uniform room ambient flow are analyzed. The results indicate that the orientation of the human body to the uniform flow plays a key role

Chylothorax due to leukemic infiltration in a patient with chronic lymphocytic leukemia

Chylothorax is characterized by accumalation of milky fluid called chyle into the plural space. Most common causes of cyhlothorax are trauma or surgery of thoracic duct and malignancies. Among the malignancies lymphoma is responsible approximately 70% of cyhlothorax but other lymphocytic tumors including chronic lymphocytic leukemia (CLL) is rarely reported. A 71 years old man with known CLL, presented with dispnea and pleural effusion and diagnosed cyhlothorax due to leukemic infiltration that confirmed by immuno flow cytometric analyse

PET/BT ve ekokardiografi ile tanı konan küçük hücreli akciğer kanserinin kardiyak metastazı

Malign tümörlerin kardiyak metastazları kalbin primer tümörlerinden daha sık görülür. Primer akciğer kanserlerinde kalbin ve perikardın lokal invazyonu sık görülür ancak lokal invazyon olmadan myokard tutulumu nadirdir. FDG PET/BT malign tümörlerin tanısal değerlendirmesinde ve evrelemesinde yaygın olarak kullanılmaktadır, ancak myokardın FDG tutulumu oldukça yoğun ve heterojendir. Bronkoskopik biyopsi ile küçük hücreli akciğer kanseri tanısı alan 55 yaşında erkek hastanın PET BT incelemesinde myokartta yoğun FDG tutulumu saptandı. Transtorasik ekokardiyografide her iki ventrikül apeksinde kitle benzeri lezyon tespit edildi. Klinik, radyolojik ve ekokardiyografik bulgularla küçük hücreli akciğer kanserinin kardiyak metastazı olarak kabul edildi ve histopatolojik incelemeye gerek görülmedi. Malign tümörlerin kardiyak metastazlarının lokal invazyon olmadan da görülebileceği ve PET BT’ nin kardiyak metastaz tanısında kullanılabileceğini göstermek için bu vakayı sunmak istedik.Cardiac metastases of malignant tumors occur more frequently than primary tumors of the heart. Local invasion of the pericardium and heart is commonly seen in primary lung cancer, but myocardial metastasis without local invasion rarely occurs. 18-F fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) is widely used in the diagnostic evaluation and staging of different malignant tumors, but the FDG uptake of myocardium is intense and heterogeneous. A-55-year old male smoker was diagnosed with small cell lung cancer (SCLC) by bronchoscopic biopsy, and FDG PET/CT showed high FDG uptake in myocardium. Transthoracic echocardiagraphy revealed mass like lesions in the apical regions of both ventricules. After systematic evaluation of imaging studies, the mass was diagnosed as intracardiac metastasis of SCLC and histopathologic examination. This case shows that intracardiac metastases of malignant tumors can be seen without local invasion, and FDG PET/CT can be a useful diagnostic tool in evaluation of intracardiac metastasi

Evaluation of Clinical Data and Mortality among COPD Patients Receiving Domiciliary NIMV Therapy

very severe chronic obstructive pulmonary disease (COPD) patients. This study was aimed to investigate the clinical data and mortality among COPD patients receiving domiciliary NIMV treatment.MATerIAL ANd MeTHods: A total of 40 COPD patients who were prescribed domiciliary NIMV at discharge between January 2010 and December 2011 were contacted by phone regarding their current health status, and the electronic patient charts of 34 patients who used NIMV regularly were retrospectively reviewed.resULTs: The mean age of the patients was 67±15 years and 59% of them were females. The mean length of hospital stay was 14.5±6.82 days. Rate of admission to intensive care unit and use of invasive mechanical ventilation was 56% and 27%, respectively. The median follow up duration was 17 months. The 6-months, 1-year, 2-years and overall mortality rates were 24%, 38%, 50% and 56%, respectively. For patients surviving at least one year after domiciliary NIMV initiation (n=21), the mean number of hospitalizations in the year before-and after-NIMV initiation were 1.38±1.28 and 0.57±0.93 (p=0.003), respectively. Mean daily NIMV use was 8.91±4.46 hours. Mean daily NIMV use of the patients with a lifespan 2 years (11.82±4.02 hours/day versus 6.0±2.62 hours/day, respectively) (p2 years (11.82±4.02 hours/day versus 6.0±2.62 hours/day, respectively) (p<0.001). Long term oxygen was prescribed for the first time to 62% of the patients using NIMV.CoNCLUsIoN: Domiciliary NIMV may have numerous beneficial effects such as decreasing hospital admissions for acute COPD exacerbations and related costs. It is very important in the battle against COPD, a disease with significant morbidity, mortality and economic burden