Cerebral hemodynamics in patients with cirrhosis

Background/Aims: Cirrhosis causes a decrease in cerebral blood flow because of a hyperdynamic circulatory state. We aimed to study the cerebral hemodynamic parameters in patients with decompensated cirrhosis and their relationship to the Child-Pugh and Model for End-Stage Liver Disease (MELD) scores. Materials and Methods: We used transcranial Doppler to investigate the cerebral hemodynamic parameters, namely the mean flow velocity of the middle cerebral artery, pulsatility index (PI), and resistive index (RI), in 50 patients who had decompensated cirrhosis and in a control group of 50 healthy people. We also investigated their relationship to the Child-Pugh and MELD scores. Results: Patients with cirrhosis had a lower mean flow velocity than those in the control group. Further, patients with cirrhosis had higher PI and RI values. There was a positive correlation between PI and the Child-Pugh score. In addition, there was a positive correlation among PI, RI, and the MELD score. The RI values of patients with ascites were higher than those of patients without ascites. Conclusion: Cerebral autoregulation might be impaired in patients with cirrhosis. Cerebral resistance proportionally increases to disease severity. There was a positive correlation among PI, RI, and MELD scores, which means that transcranial Doppler might be useful not only in the follow-up of the severity of the disease but also in determining the survival of these patients. © Copyright 2016 by The Turkish Society of Gastroenterology

Arachnoid cysts

Arachnoid cysts are cavities with a content similar to cerebrospinal fluid, frequently communicating with the subarachnoid space. They make up 1% of the intracranial space occupying lesions. They are developmental anomalies which may be clinically asymptomatic. The most frequent clinical findings are headache, macrocephaly, epileptic seizures, focal nerological signs and intracranial hypertansion. Rarely they cause optic neuritis, endocrinological dysfunction, cerebellar dysfunction, hemifascial spasm. They are most commonly located in the middle fossa of the cranium. Subdural hematomas and hygromas are infrequently encountered complications of arachnoid cysts of the middle cranial fossa. Spinal arachnoid cysts are mostly diagnosed accidentally or they may present with limb weakness, neuropathic pain, parestesia or myelopathy. In this review localization, clinical features, some unusual syndromes and treatment options of arachnoid cysts are discussed.Araknoid kistler beyin-omurilik sıvısı (BOS) benzeri sıvı içeren, subaraknoidal boslukla iliskisi olan kistik kavitelerdir. Beyinde tüm yer kaplayan olusumların %1'ini olustururlar.Çogunlukla asemptomatiktirler.Tümyas gruplarında gelisebilmekle birlikte genellikle çocukluk çagına kadar olusmaktadırlar. Basagrısı, makrosefali, konvülziyon, fokal nörolojik belirtiler, kafa içi basınç artısı gibi bulgular verebilirler. Nadiren endokrin anormallikler, optik nörit, serebellar disfonksiyon, hidrosefali, hemifasyal spazma neden olurlar. En sık görüldükleri bölge orta çukurdur. Orta çukur yerlesimli araknoid kistlerde nadiren subdural hematom ve higroma gibi komplikasyonlar gelisebilmektedir. Spinal araknoid kistler genellikle tesadüfen tesbit edilirler. Ekstremite güçsüzlügü, nöropatik agrı, parestezi, myelopati ile prezente olabilirler.Bu derlemede serebral ve spinal araknoid kistlerin yerlesimi, klinik bulguları, bazı nadir klinik görünüm sekilleri, görüntüleme yöntemleri ve tedavisi anlatılacaktır

Karpal tünel sendromlu hastalarda elektrodiyagnostik tanı ile Washington Nöropatik Ağrı Ölçeği arasındaki ilişki

Objectives: We undertook this study to examine the relationships between clinical symptoms as evaluated by Washington Neuropathic Pain Scale (NPS) and electrodiagnostic classification in patients with carpal tunnel syndrome (CTS). Methods: Eighty patients with unilateral CTS were included in this study. After diagnosis of CTS by electromyography, all patients completed a 10-item questionnaire (NPS). Results: A statistically significant correlation between total NPS score and severity of CTS was found (p=0.013, r=0.276). Conclusion: The present study indicates that using NPS might be useful in evaluating the clinical outcome of patients with CTS

İzole baş ağrısı bulgusu veren serebral ven trombozları

OBJECTIVE: The aim of this study is to demonstrate the demogrophical specialities and clinical features among patients with cerebral venous thrombosis (CVT), who had admitted to our department between 2006 and 2012 and who had headache as the only presenting symptom. MATERIAL and METHODS: Thirty-two patients who had diagnosed as CVT between 2006-2012 were evaluated and 12 of them who had headache as the only presenting symptom were included to the study. RESULTS: Headache was only symptom of CVT in 12 patients (10 Female, 2 Male). 8 of these 12 patients had papilledema. 4 patients had only headache without additional sign. The lateral sinus was the most frequently involved sinus. CONCLUSION: The headache is usually progressive over a few days, but a few patients have sudden onset or even a thunderclap headache. The outcome of CVT patients with isolated headache diagnosed was favourable

Giant arachnoid granulation in a patient with benign intracranial hypertension (2009: 1b)

We report magnetic resonance (MR), computed tomography (CT) and angiographic imaging of an unusual giant arachnoid granulation 7(GAG) in the superior sagittal sinus in a man with headache and vertigo. Intrasinus pressure measurements revealed a significant pressure gradient across the lesion. MR imaging is useful to identify GAG and dural sinus thrombosis, whereas dural sinus pressure measurement in certain cases of GAGs can be used to evaluate the lesion as the cause of the patient's symptoms

155 mm. MKE 274 uzun menzilli topçu mühimmatı sevk çemberi kaynak prosesinin yapay sinir ağları ile iyileştirilerek hatalı ürün özelliklerinin azaltılması

Tez (Yüksek Lisans) -- Kırıkkale Üniversitesi89291

Reducing rates of faulty products of 155 mm. MKE mod 274 long-range artillery ammunition rotating band welding process with artificial neural network

YÖK Tez ID: 344002Bu çalışmada, Makina ve Kimya Endüstrisi Kurumu (MKEK) Mühimmat Fabrikası, tarafından tasarlanan 155mm. MKE MOD 274 Mühimmatının, üretimindeki özel proseslerden bir tanesi olan sevk çemberi kaynak prosesi Yapay Zeka Teknikleri kullanılarak kontrol altına alınmıştır.Sevk çemberi, mühimmatın namlu içerisinde ?yiv-set?lere oturarak dönü kazanmasını ve istenilen hedefe ulaşmasını sağlar. Sevk çemberi, bakır ve pirinç tellerin çelik gövdeyi aşındırarak gövde üzerine kaynaması sonucu oluşur. Sevk çemberi, MIG (Metal Inert Gas) kaynak yöntemi kullanılarak yapılan dolgu kaynağı (overlay welding) ile oluşturulur.Kaynak prosesi 22 girdi parametresi ve 3 çıktı parametresinden oluşmaktadır. Çok sayıdaki girdi parametrelerinin birbiriyle etkileşimi ve bu etkileşimin çıktı parametrelerine yansıması tam olarak bilinmemektedir. Bu durumda proses kontrol altında tutulamamaktadır.Prosesten elde edilen 101 adet veri yardımıyla Yapay Sinir Ağı (YSA) modelleri hazırlanmış ve test edilmiştir. İlk tahmin modelleriyle çıktılar %99,9 doğrulukta tahmin edilmiştir. Girdi parametreleri sayısı Pareto Analizi yöntemi ile 9'a indirgenmiştir. Bunun sonrasında sınıflandırma modelleri geliştirilmiş ve çıktıların doğru tahmin edildiği görülmüştür. Son olarak hedeflenen çıktılara ulaşmak için olması gereken girdi parametre değerlerini bulmayı hedefleyen girdi tahmin modelleri oluşturulmuştur. Bu model sayesinde uygun çıktılara ulaşmak için girdi parametrelerinin minimum ve maximum sınırları belirlenmiştir.Böylece bir kaynak prosesindeki girdi parametrelerinin kontrol altında tutulması ve çok sayıda hatalı parça üretilen bir iş istasyonunda hatalı parça sayısını minimize etmek hedefine ulaşılmış ve YSA Yönteminin bu proseste kullanılabileceği görülmüştür. YSA Yöntemi ile girdi ve çıktılar arasında ilişkilerin tespit edilerek, ele alınan kalite kontrol problemlerinin minimize edilmesinin mümkün olduğu görülmüştür.In this study, 155mm. MKE MOD 274 Ammunition, designed by Mechanical and Chemical Industry Corporation (MKEK) Ammunition Factory is analyzed, which is one special rotating band welding process is controlled by using Artificial Intelligence Techniques

Giovanni Battista Morgagni (1682–1771)

Giovanni Battista Morgagni (1682–1771) is considered the father of neuropathology and one of the most important innovators in the history of medicine. In his “opus magnum” De sedibus et causis morborum per anatomen indagatis (The Seats and causes of diseases investigated by anatomy), he established pathological anatomy as a science by correlating clinical histories with autopsy findings. © 2015, Springer-Verlag Berlin Heidelberg

Unilateral thalamodiencephalic syndrome presenting with severe hypersomnia

Thalamic and brainstem strokes can cause organic hypersomnia. Paramedian thalamus is believed to play an important role in the regulation of sleep, and disturbances of sleep regulation are known to occur in paramedian thalamic stroke (PTS). In patients with PTS, slight sleepiness is reported with unilateral and limited lesions. In this paper we report on a patient presenting with severe hypersomnia who has a limited, unilateral thalamodiencephalic ischemic lesion on magnetic resonance imaging (MRI). A 54 year-old man referred to our hospital with the complaint of excessive day time sleepiness. His cranial MRI revealed a unilateral ischaemic lesion beginning at the level of left thalamus and extending to nucleus Ruber and Edinger Westpall. His total day time sleep was about 23-24 hours in the first week. He had been put on dopamine agonist therapy (bromocriptine 2.5mg/day up to dose 7.5mg/day). During this medication his total day time sleep decreased gradually and after two months he returned to his normal vigilance. Lesions affecting thalamus and mesencephalic or pontine tegmental reticular formation are a cause of hypersomnia but clinical presentation and degree of hypersomnia can be various due to the affected region of the brain. We think that regulation of sleep and wakefulness by different brain structures are still elusive and new case reports and clinical trials would be helpful about clarification of this condition