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Gunbey E.,Ondokuz Mayis University | Acar B.,Kecioren Training and Research Hospital | Tuncay K.S.,Halil Sivgin Cubuk State Hospital | Guven S.F.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | Karasen R.M.,Gazi University
Acta Medica Mediterranea

Objective: To assess the influence of upper airway sensory dysfunction on the respiratory events during sleep in patients with obstructive sleep apnea syndrome (OSAS). Methods: Our study was performed over 30 patients with OSAS. The patients underwent a second night polisomnography (PSG) after bupivacaine application to uvula and soft palate and the outcomes of both PSG results were compared. Results: In PSG-2, the mean Apnea-hypopnea index (AHI), AHI-supine, AHI-right lateral, AHI-REM and AHI-nonREM values were significantly higher than the same data acquired in PSG-1 (p<0.001, p=0.001, p<0.001, p<0.001, and p=0.001, respectively). In PSG-2, mean and minimum arterial O2 saturation were significantly lower compared to PSG-1 (p=0.021 and p=0.039, respectively). The correlation analysis of PSG-2 showed that AHI-nonREM and AHI-supine are more effected from the sensorial blockade. Conclusion: Our study showed that, when the protective neuromuscular mechanism is removed by upper airway sensory blockage, the severity of OSAS increases. Upper airway sensorial blockade more influentially effects respiratory events in supine position and in non-REM phase. Source

Yildiz F.,Kocaeli University | Oguzulgen I.K.,Gazi University | Dursun B.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | Mungan D.,Ankara University | And 2 more authors.
Tuberkuloz ve Toraks

Asthma still has high morbidity and cost despite all advances in pathogenesis, diagnosis and treatment. Although asthma can be controlled with proper diagnosis and treatment, the low rates of control in our country and in the world can not be attributed to the variable course of the disease and patients' psycho-social behaviours for chronic disease. In this context, Turkish Thoracic Society (TTS) has decided to update Asthma Diagnosis and Management Guide latest published in 2000. National data were collected, compiled and prepared by authors, and final form given by the TTS Asthma and Allergy Study Group, after presenting to consultant individuals and institutions. In June 2009, the National Asthma Management and Prevention Guideline were published in Turkish. In this paper, we aimed to present the national guide in English with its basics and individual differences. Source

Findik G.,Ataturk Chest Diseases and Chest Surgery Training and Research Hospital | Gezer S.,Duzce University | Aydogdu K.,Ataturk Chest Diseases and Chest Surgery Training and Research Hospital | Oz G.,Ataturk Chest Diseases and Chest Surgery Training and Research Hospital | And 4 more authors.
Thoracic and Cardiovascular Surgeon

Objective: Povidone-iodine (PI) is an effective disinfectant used in many surgical operations. It is known that PI is absorbed by the skin after application. Absorption is even greater in infants, as their skin is thinner and more permeable. Iodine absorption in the orbita, neck and during abdominal surgery has been previously investigated, but such a study has not been performed for the pleura, which has a greater area and capacity for absorption. In this study, we investigated the effect of intraoperative povidone-iodine lavage on thyroid hormones during thoracic surgery. Material and Method: Fifty patients without any thyroid pathology scheduled for thoracotomy were divided into 2 groups. Group A (n=25) was given intraoperative saline lavage, while group B (n=25) had povidone-iodine lavage. Levels of free T3 (FT3), free T4 (FT4) and thyroid-stimulating hormone (TSH) measured 1 day preoperatively and 1 day postoperatively were analyzed. Results: There was a statistically meaningful change in FT3 levels (p=0.033) between groups, but the measured changes in FT4 and TSH levels were not statistically significant (p=0.98 and p=0.71, respectively). FT3 scores for group A were decreased postoperatively compared to the scores for group B, but all results were in normal ranges. In group A, the changes between preoperative and postoperative levels of FT3 and FT4 were statistically significant, while changes in TSH levels were not. In group B, changes in FT4 levels were statistically significant and changes in FT3 and TSH levels were not. Conclusions: The scores show that the iodine absorbed by the pleura during intraoperative povidone-iodine lavage has an effect on thyroid function. Intrapleural PI lavage results in changes to some thyroid hormone levels due to pleural absorption. Thus, intrapleural PI lavage should be used with care. © Georg Thieme Verlag KG Stuttgart. Source

Turkoz F.P.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | Solak M.,Hacettepe University | Kilickap S.,Hacettepe University | Ulas A.,Ankara Ataturk Training and Research Hospital | And 3 more authors.
Journal of Gastric Cancer

Results: The incidence of bone metastasis was 3.8%. The most common histopathological subtype was adenocarcinoma (79%) with poor differentiation (60.8%). The median interval from the diagnosis to bone metastasis was 11 months. The median survival time after bone metastasis was 5.4 months. Factors that were associated with longer median survival times included the following: isolated bone metastasis (P=0.004), well-differentiated tumors (P=0.002), palliative chemotherapy (P=0.003), zoledronic acid treatment (P<0.001), no smoking history (P=0.007), and no metastatic gastric cancer at the time of diagnosis (P=0.01). On the other hand, high levels of lactate dehydrogenase (LDH) (hazard ratio [HR]: 1.86; P=0.015), carcinoembryonic antigen (CEA) (HR: 2.04; P=0.002), and carbohydrate antigen (CA) 19-9 (HR: 2.94; P<0.001) were associated with shorter survival times. In multivariate analysis, receiving zoledronic acid (P<0.001) and performance status (P=0.013) were independent prognostic factors.Purpose: To evaluate the incidence, clinicopathological characteristics, treatment outcomes, prognostic factors, and survival of gastric cancer patients with bone metastases.Materials and Methods: Of 4,617 gastric cancer patients who were treated between 2001 and 2013, 176 patients with bone metastases were analyzed.Conclusions: Smoking history, poor performance status, poorly differentiated adenocarcinoma, and high levels of LDH, CEA, and CA 19-9 were shown to be poor prognostic factors, while receiving chemotherapy and zoledronic acid were associated with prolonged survival in gastric cancer patients with bone metastases. © 2014 by The Korean Gastric Cancer Association. Source

Aydogdu K.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | Sahin F.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | Incekara F.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | Fndk G.,Ataturk Chest Disease and Chest Surgery Training and Research Hospital | And 2 more authors.
Turk Toraks Dergisi

Parathyroid cysts are unilocular, thin-walled cysts, and they are seen very rarely. Their formation mechanisms are not clear. They are usually localized in the cervical region, and mediastinal settlements are rare. They are usually asymptomatic, but cysts that have settled in the neck may be symptomatic, such as tracheal pressure symptoms. There are two types-namely, functional cysts and non-functional cysts-depending on their hormonal characteristics. There are still difficulties in the diagnosis, and they can be mistaken by thyroid pathology. Treatment is surgery. We discussed two cases of parathyroid cysts that we surgically excised. © 2015 by Turkish Thoracic Society. Source

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