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Aim: Obstructive sleep apnea (OSA) characterized by repetitive collapse of the upper airway during sleep and thiscondition leading to oxygen desaturation, sympathetic activation, and recurrent arousals. Patients who experience sleepproblems consider themselves, less able to control impulsive, aggressive tendencies. The aim of this study was toinvestigate the effect of OSA and daytime sleepiness on violent and non-violent behaviors.Material and Methods: Hundred fifty individuals who were admitted to the Chest Disease Polyclinic for SleepDisorders of Duzce University, School of Medicine Hospital were included in the study. All patients underwentpolysomnography (PSG). All tests [Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), EpworthSleepiness Scale (ESS) and Nonviolent and Violent Offending Behavior Scale (NVOBS)] were applied to allparticipants by face to face interview.Results: In this study, no significant relationship was found between NVOBS and AHI in OSA patients. Patients withOSA; There was a significant relationship between total score of NVOBS and ESS (r=0.267 p=0.003). There was asignificant relationship between the ESS score and the BDI score (r=0.314 p

Kartagener syndrome is a rare autosomal recessive disorder seen about in one per 30000 live births and characterized by bronchiectasis, chronic sinusitis and situs inversus triad. Absence of dynein arms in epithelial cilia is the most common defect in electron microscopic examination. Extreme sputum retention is seen due to cilial disfunction in this disease. Treatment of the disease is directed to symptoms. Infertility and deafness can be seen. It has been also observed that Kartagener syndrome decreases sleep quality. In order to protect the patients from infections, chest physiotherapy, influenza and pneumococcal vaccines are recommended. These patients should stay away from particulate included gases such as dust and smoke. In this study, a 33 year old male patient diagnosed late despite frequent hospital admissions, coexistence with obstructive sleep apnea syndrome was presented with clinical and radiological findings. © 2019, Duzce University Medical School. All rights reserved.

Aim: Psoriasis is a frequently seen chronic systemic inflammatory disease accompanied by several comorbid conditions that affects 2-3% of the general population. One of the comorbidities rarely accompanying psoriasis is obstructive sleep apnea syndrome (OSAS). OSAS is a disease characterized by recurrent complete (apnea) or partial (hypopnea) upper airway obstruction episodes and frequently by decreased blood oxygen saturation. The purpose of this study was to evaluate the risk factors for OSAS by investigating OSAS symptoms in psoriasis patients. Material and Methods: Eighty-two patients aged over 16, diagnosed with psoriasis, and under follow-up by the Duzce University Medical of Faculty, Dermatology and Venereal Diseases Polyclinic, Turkey, were included in the study. Patients’ OSAS symptoms were investigated. The Epworth Sleepiness Scale was used to assess excessive daytime somnolence. Results: Of the patients 51.2% (n=42) were male and 48.8% (n=40) female. Patients’ mean age was 47.09±14.10 years. Patients’ mean time of psoriasis diagnosis was 16.97±10.55 years, and mean Psoriatic Area Severity Index (PASI) score was 11.25±6.32. Severe disease was present in 54.9% of patients (n=45) based on PASI classification. Prevalence of 56.1% for snoring, 25.6% for excessive daytime sleepiness, and 15.9% for witnessed apnea were determined in these patients. Forty-seven (57.3%) cases had at least one major symptom. The most common minor symptoms were inability to sleep with 25.6% (n=21) and insufficient disrupted sleep with 22.0% (n=18). Conclusion: Prevalence of OSAS symptoms in psoriasis patients were found high. Psoriasis patients with OSAS symptoms must be referred to relevant specialists for polysomnographic evaluation. © 2019, Duzce University Medical School. All rights reserved. Amaç: Psoriazis toplumda sık görülen, genel nüfusun %2-3’ünü etkileyen, birçok komorbiditenin eşlik ettiği kronik sistemik enflamatuvar bir hastalıktır. Psoriazis’e eşlik eden nadir görülen komorbiditeler arasında obstrüktif uyku apne sendromu (OUAS) yer almaktadır. OUAS uyku sırasında tekrarlayan tam (apne) veya parsiyel (hipopne) üst solunum yolu obstrüksiyonu epizodları ve sıklıkla kan oksijen satürasyonunda azalma ile karakterize bir hastalıktır. Bu çalışmanın amacı psoriazis hastalarında OUAS semptomları sorgulanarak, OUAS risk faktörlerini değerlendirmektir. Gereç ve Yöntemler: Düzce Üniversitesi Tıp Fakültesi Deri ve Zührevi Hastalıkları polikliniğinden takipli ve Psoriazis tanılı 16 yaşından büyük 82 hasta çalışmaya alındı. Hastalar OUAS semptomları açısından sorgulandı. Aşırı gündüz uykululuğu değerlendirmek için ise Epworth uykululuk skalası kullanıldı. Bulgular: Hastaların %51,2 (n=42)’sı erkek, %48,8 (n=40)’i kadındı. Hastaların yaş ortalaması 47,09±14,10 yıl idi. Hastaların ortalama psoriazis tanı süreleri 16,97±10,55 yıl, ortalama Psoriatik Alan Şiddet İndeksi (PAŞİ) 11,25±6,32 idi. PAŞİ sınıflamasına göre hastaların %54,9 (n=45)’ü şiddetliydi. Bu hastalarda horlama için %56,1, gündüz aşırı uyku hali için %25,6, tanıklı apne için %15,9’luk prevalans saptandı. En az bir semptomu olan olgu sayısı 47 (%57,3) idi. Minör semptomlar sorgulandığında en sık gözlenen %25,6 (n=21) ile uyuyamama ve %22,0 (n=18) ile yetersiz bölünmüş uyku şikayetiydi. Sonuç: Psoriazis hastalarında OUAS semptom sıklığı yüksek olarak bulunmuştur. OUAS semptomları olan psoriazis hastaları muhakkak polisomnografik değerlendirme için ilgili uzmanlara yönlendirilmelidir.

WOS: 000480511400054 The use of natural gas for heating purposes causes less air pollution than solid fuels. Preventing air pollution decreases hospital admissions due to respiratory infections in children. The aim of the study is to examine the impact of using more clean fuel for heating purpose on hospital admissions with respiratory tract diseases in children. The records of 126.940 pediatric patients who were admitted to Duzce University Medical Faculty Pediatric Emergency Medicine outpatient clinic between 2014 and 2017 were reviewed. The records of children diagnosed with respiratory diseases (n: 46137) were examined. During the same period, air monitoring measurements of the national air quality network were recorded. Of the children, 55.5% were male and 45.5% were female. Most of the children were among the age group of 2-5 years (44%). Between 2014 and 2017, the mean PM10 was observed to decrease (2014: 114.4, 2017:79, p < 0.0001), rate of natural gas usage (2014:52.9%, 2017: 64.2%, p

Aim: The aim of this study, is to evaluate the consistency with the polysomnography (PSG) data of the patients and the data reported by the patients themselves after PSG examination in the morning. Material and Methods: One hundred and thirty-four consecutive individuals who were admitted to the Chest Disease Polyclinic for Sleep Disorders of Duzce University Medical Faculty were included in the study. PSG and the questions related to sleep perception was applied by the same physician with face to face interview to all participants. Results: Of the patients included in the study 90 (67.2%) were male and 44 (32.8%) were female, and the mean age was 47.3±12.6 years. While there was a significant correlation (p=0.042, r=0.301) between the sleep time reported by the patients themselves after waking up in the morning and the sleep time measured by the PSG in patients without obstructive sleep apnea (OSA), there was no correlation in OSA (+) patients (p=0.269, r=0.125). Similarly, while there was a significant correlation (p=0.026, r=0.352) between the sleep latency reported by the patients themselves after waking up in the morning and the sleep latency measured by the PSG in OSA (-) patients, there was no correlation in OSA (+) patients (p=0.060, r=0.223). Conclusion: While evaluating OSA patients and explaining their treatment before and after PSG, it should be kept in mind that they might have impaired perception. Therefore, we thought that we should spend more time to patients, and to make our explanations more clearly and understandably. © 2019, Duzce University Medical School. All rights reserved.

A 59-year-old female patient was admitted to outpatient clinic with a 3-week dry cough and a 2-month exercise dyspnea (MRC 2). Within the last 3 months there was a loss of 5 kg. She has never smoked. She was a housewife. In thoracic computed tomography of the patient’s postero-anterior chest x-ray, the right lower quadrant is the opacity of the right atrium. A large number of nodules (5 mm in size) in both upper lobes of the lungs, and a common reticulonodular dancer in the middle lobe of the right lingula. The desired positron emission tomography of the patient with malignancy pre-diagnosis; right lobe of the lungs, reticular densities in the left lung, gastroesophageal junction, stomach fundus and large curvature in the dorsal wall of the nasopharynx, bilateral cervical lymphadenopathies, bilateral cervical lymphadenopathies, bilateral lymph nodes, right lobe of the lungs, right scapula and left iliac bone intense hypermetabolic involvement was detected. The axillary lymph node dissection was diagnosed as granulomatous lymphadenitis. The patient was accepted as sarcoidosis, inhaled steroid therapy was initiated and followed. © 2017, Duzce University Medical School. All rights reserved.

Amaç: Bu çalışmada Göğüs hastalıkları polikliniğine başvurmuş hastalardan istenen Toraks Bilgisayarlı Tomografileri (BT)nin hangi nedenlerle istendiğini ve saptanan radyolojik anormallikleri araştırmak amaçlandı. Yöntem : Tıp Fakültesi Göğüs Hastalıkları polikli niğinde 3 ay boyunca bakılmış tüm hastalardan istenmiş Toraks BTler retrospektif olarak değerlendirildi. Bulgular: 3245 hastanın 215ìnden (%6.62) Toraks BT istenmişti. Yaş ortalamaları 5814.97 olan 215 hastanın 142sı erkek (%66) idi. International Clas sification of Diseases (ICD) kodlarına bakıldığında en sık 57 (%26.5) hastada öksürük, 49 (%22,8) hastada akciğerin tanısal görüntülenmesinde anormal bulgular ve 18 (%8.4) hastada da hemoptizi tanılarıyla Toraks BT istenmişti. İstenen tomografilerin 185 (% 86)sında patoloji saptanmıştı. En sık görülen radyolojik anormallikler sırasıyla lenfadenopati 69 (%32,1), nodül 60 (%27.9), fibrotik değişiklik 49 (%22.8) idi. Bronş kanseri tanısıyla istenen Toraks BTlerin %100 ünde klinik olarak önemli en az bir pato loji saptanmışken, göğüs ağrısı tanısıyla istenenlerin ise %55.6sında klinik olarak önemli patoloji saptanmamıştı. Sonuç : Üçüncü basamak bir göğüs hastalıkları polikliniğinden istenen Toraks BTlerin çoğunda patolojik bulgu saptandığı görüldü. ICD kodları nın hastanın tanısından çok şikayetine göre girildiği saptandı. Objective : The aim of this study was to investigate Thoracic Computed Tomography (TCT) of the patients attended to the outpatient clinic of chest diseases regarding to reasons in which CT wa s prompted and which radiological abnormalities was found. Method : TCT of the patients attended to the outpatient clinic of chest diseases department of Faculty of Medicine was evaluated. Results : TCT was prompted 215 out of 3245 patients (%6.62). The mean age was 58±14.97 (142 male, %66). According to the International Classification of Diseases (ICD) the reasons for prompting TCT were cough in 57 (%26.5), abnormal radiological findings in chest PA film in 49 (%22.8), hemoptysis in 18 (%8.4) of patients. T here was at least one pathology in 185 of TCT (%86). The most common radiological abnormalities were lymphadenopathy in 69 (%32.1), nodüle in 60 (%27.9), fibrotic changes in 49 (%22.8) of 215 TCT. There was at least one pathology in TCT prompted in all patients with the diagnosis of broncheal carcinoma whereas there was no any pathology in %55.6 of patients with chest pain. Conclusion : There was any kind of radiological finding in most of TCT prompted from a chest disease polyclinic of tertiary hospital. The respiratory complaints were coded instead of ICD codes as a patient diagnosis.

Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000451979404055 …

Otuz sekiz yaşında erkek hasta kliniğimize göz yaşar- tıcı gaz maruziyeti sonrası başvurdu. PA Akciğer grafi- sinde interstisyel özellik izlendi. Solunum fonksiyon testinde restriktif patern saptandı. Hastanın bir hafta sonra yapılan solunum fonksiyon testlerinde, zorlu vital kapasitenin maruziyetten hemen sonraki döneme oranla arttığı ancak maruziyet öncesine göre hala düşük seyrettiği görüldü. Göz yaşartıcı gaz inhalasyo- nu sonrası gelişen pulmoner restriksiyon olgusunu sunuyoruz. A 38-year-old man was admitted to our clinic after tear gas inhalation. An interstitial pattern was ob- served in the posteroanterior chest x-ray. The pulmo- nary function test indicated a restrictive pattern. Forced vital capacity increased after a week; howev- er, it did not reach the basal value. Herein, we report a case of tear gas inhalation induced pulmonary restriction.

Ağızdan kan gelme şikayeti ile başvuran ve anestezi teknisyeni olduğunu belirten 37 yaşında erkek hasta hemoptizi etyolojisi araştırılmak amacıyla yatırıldı. Hastaya çekilen toraks tomografisinde herhangi bir pulmoner patoloji saptanmadı. Bronkoskopik, laringoskopik, ekokardiyografik ve nazogastrik değerlendirmelerde herhangi bir patoloji saptanmadı. Hastanın elinde bir üniversiteden alınmış evre 4 mide adenokarsinomu olduğunu belirtir rapor bulunmaktaydı. Hasta servis takiplerinde ağrı yakınması olduğunu ifade ederek ısrarla narkotik analjezik talebinde bulundu. Hastanın çelişkili ifadeleri, fizik muayenede kollarda kesi izleri saptanması ve yoksunluk sendromu benzeri belirtileri olması üzerine hastanın kimliği ve iddia ettiği malignite tanısı hakkında şüphelerimiz oluştu. Sonraki hemşire izlemlerinde tesadüfen hastanın intravenöz kanülden enjektörle aldığı kanı ağızdan geliyormuş gibi tükürdüğü gözlemlendi. Sonuç olarak; intravenöz ilaç bağımlılarında gelişebilecek özellikle kardiyolojik veya pulmoner hemoptizi nedenlerinden başka bu olguda olduğu gibi beklenmedik nedenleri de göz ardı etmemeliyiz. Faktitiyöz neden; özellikle tıbbi öyküsü olan ve şüpheli davranış sergileyen olgularda etyolojisi aydınlatılamayan hemoptizi ayırıcı tanısında mutlaka düşünülmelidir., A 37-yr-old man, claiming to be anesthetist, was admitted with a history of repeated haemoptysis. No any pulmonary pathology was present in thorax computerized scan of patient. Emergency bronchoscopy, laryngoscopy, echocardiography and nasogastric evaluation revealed no pathology. Patient had a report from a university hospital diagnosed as stage four gastric adenocarcinoma with no further detail. During hospitalization, he demanded narcotic analgesic for pain. But, due to conflicting statements of the patient, determination of the incision scars on the arms in physical examination and abstinence syndromelike symptoms, doubts about the patient's identity and the diagnosis of malignancy have arisen. During follow up, nurse has noticed that he took blood from his intravenous route and put it into his mouth and after that expectorated it. As a conclusion, in intravenous drug users not only usual causes of hemoptysis, commonly cardiological and pulmonary causes, but also unusual causes of hemoptysis have to be thought. A factitious cause should be considered in the differential diagnosis of hemoptysis of unclear etiology, especially when the medical history or the patient's behavior is unusual.

Göğüs hastalıkları servisinde izlenen 90 yaş ve üzeri geriatrik hastaların değerlendirilmesi Giriş: Ülkemizde geriatri kliniklerinin say ıs ın ın az olması nedeniyle birçok merkezde gö ğüs hastalıkları uzmanları bu hasta grubunungr tan ı, ta k ip ve te davisin de önem li ro l oynama k ta dır. Bu ça lışma da gö ğüs h asta lıkları servislerin de yatırılara k izlenen 90 ya ş ve üzeriş geriatrik hastaların akciğer hastalıkların seyrini ara ştırmak amaçlanm ıştır. Materyal ve Metod: Ocak 2010-Aralık 2012 tarihleri arasında üç yıl süresince Düzce Üniversitesi Tıp Fakültesi ve Düzce Atatürke Devlet Hastanesi Gö ğüs Hasta lıkları servislerin de yatırılan 90 ya ş ve üzeri geriatrik h asta ların dosya ları retrospe k tif o lara k in c e len di.nc B ulgular: Ça lışmam ızda de ğerlen dirilen ya ş orta lama ları 93.3 3.9 olan 52 geriatrik hastan ın 30 (%57.7)u ka dın, 22 (%% 42.3)si % erke kti. En fazla yatışın pnömoni ne den li o ldu ğu gözlen di (%65.4). Pnömoni o lgu larına en sık h ipertansiyon e k h asta lık o la ra k e şlika etme kteydi (%51.6). Hipertansiyon dan sonra sırasıyla dia b etes me llitus ve konjestif ka lp yetmezliği e ş lik etme kteydi. Tüm h a sta larınha %80.8inde e şlik eden en az bir ek hastalık mevcuttu. Tüm hastaların mortalite oran ı %17.3 idi. Sonu ç : Doksan ya ş ve üzeri geriatrik hastalıklarda gö ğüs hastalıkları servislerine en sık yatırılma nedeni pnömoni ve en s ık e şlik edene ş e k h asta lık da hipertansiyon o lara k saptan dı. Hasta ların ço ğu şifayla ta b urcu e dile b ilmiştir. Do lay ısıyla, 90 ya ş ve üzeri olgu larda ilerilatetkik ve tedavi yöntemlerinin uygulanması gerektiğidüşünülmektedir. Introductio n : Since th e num b er of geriatric clinics in our country is ina dequate, Chest ph ysicians play a very important ro le in diagnosis, follow-up and treatment of that group of patients in many centers. In this study, 90 years and older geriatric patients hospitalized in pgygggpulmonolo gy services was investigated re garding course of disease.ildhdMater ials and Methods: Ninety years and older geriatric patients hospitalized in Pulmonology Department of Duzce University and Ninety years an d older geriatric patients h ospitalized in Pulmonology Department of Duzce University an d Duzce Ataturk State Hospital was retrospectively analyzed durin g th ree-year period between January 2010 an d December 2012. Results: Th irty (57.7%) out of 52 patients was women. Th e mean a ge was 93.3 ± 3.9. Th e most common cause of admission was ppneumonia (65.4%). Hypertension was th e most common concomitant disease (51.6%). Diabetes me llitus, con gestive h eart failure twas oth er most common concomitant disease, res pectively. 80.8% of all patients was accom panied by at least one concomitan t disease. All patients h a d a morta lity rate of 17.3% . Conclusion: Th e most common cause of admission an d concomitant disease in 90 years an d older geriatric patients was pneumonia and hypertension respectively. Most of the patients discharged from hospital. Further examination and treatment in patients over the a ge of 90 sh ould be implemented.

Silan, Coskun/0000-0002-8352-6571; silan, coskun/0000-0002-8352-6571 WOS: 000333080000018 Hipoksik pulmoner vazokonstriksiyon akcigerlerde ventilasyon perfüzyon dengesini saglayan fizyolojik uyum mekanizmasidir. Hipoksemi ile seyreden progressif akciger hastaliklarmin patogenezinde önemli rol oynamakia birlikte saglikli bireylerde de görülmektedir. Yogun çali5malara ragmen, hipoksik pulmoner vazokonstriksiyonun mekanizmasi henüz bulunamamijtir. G proteinleri vasküler endotel ve düz kas hücrelerinde reseptör aracilikli sinyal iletimine aracilik ederek vasküler tonusun düzenlenmesinde önemli rol oynayan membrana bagli protein ailesidir. Biz bu çalijmada, kuzu izole pulmoner arterierinde izlenen hipoksik vazokonstriksiyonun oluj mekanizmasinda G, ve G^ proteinlerlnin rolünüsaptamayiamacladik. Pulmoner arterler yeni kesilmi5 kuzularin sol akciger alt loblarmdanizole edildi. ArterlerKrebs-Henseleitsolüsyonu ile dolu olan izole organ banyosuna asildi ve izometrik kontraksiyonlar bilgisayarli poligrafi sistemi ile baglantili olan izometrik transdüsir yoluyla devamli olarak kaydedildi. Solüsyon %75 N^- %20 0^- %5 COj (Normoksik) ve %95 N^- %5 COj (Hipoksik) kari^imi içeren gaziar ile havalandinidi. Organ banyosundaki parsiyel oksijen konsantrasyonu oksijen elektrodu kullanilarak sürekli olarak ölcüldü. G¡ ve G^ proteinlerin rolünü ara^tirmak için kolera ve pertusis toksini kullanildi. Çali^mada, dinlenme gerimindeki geni? çapli pulmoner arterlerde hipoksiye bagli bir gerim artiji izlenmedi ancak hipoksi 3 ^ilVl 5-HT ile prekontrakte edilmi? dokularda kontraksiyona (1.7+0.5 mN/mm^ n=10) sebep oldu. Hipoksik vazokonstriksiyon 2 |ig/ml kolera toksini ile inkübasyon sonrasi inhibe (2.6±0.4 mN/mm^'den 1.0±0.4 mN/mm^'ye kadar, n=6) ve 2 (ig/ml pertusis toksini ile inkübasyon sonrasi potansiyalize (0.6±0.4 mN/mm^'den 1.7±0.3 mN/mm^'ye kadar, n=6) oldu. Bu sonuçlar G¡ ve G, proteinleri ile iliçkili sinyal iletiminin geni? çapli kuzu izole pulmoner arterinde gelljen hipoksik vazokonstriksiyonda önemli bir mekanizma olabilecegini gösterdi. Hypoxic pulmonary vasoconstriction (HPV) is an intrapulmonary adaptive mechanism that matches alveolar ventilation to perfusion. However during prolonged alveolar hypoxia HPV occurs with many pulmonary diseases. Despite intensive studies, cellular mechanisms of HPV are still not well defined. G proteins are a family of membrane-associated proteins believed to be involved in the transduction of various signals including the regulation of vascular tonus. In this study, we aimed to determine the contribution of G(i) and G(s) proteins in hypoxic vasoconstriction of lamb isolated pulmonary artery rings. Pulmonary arteries were isolated from left lower lobe of freshly slaughtered lamb. Arteries suspended in an organ bath filled with Krebs-Henseleit solution and isometric contraction recorded continuously via an isometric transducer connected to a computerised polygraphy system. The solution aerated with 75% N-2 - 20% O-2 - 5% CO2 (normoxic) and 95% N-2 - 5% CO2 (hypoxic) pO(2) of bathing medium was measured continuosly using an oxygen electrode. Pertussis toxin and cholera toxin were used to investigate the role of G(i) and G(s) proteins. In the present study, we observed that hypoxia had no effect on resting force in large artery rings, but it caused a further contraction (1.7 +/- 0.5 mN/mm(2), n=10) in 3 mu M 5-HT precontracted pulmonary arteries rings. Hypoxic vasoconstriction was inhibited by preincubation with 2 mu g/ml cholera toxins (from 2.6 +/- 0.4 mN/mm(2), to 1.0 +/- 0.4 mN/mm(2), n=6) and potentiated by preincubation with pertussis toxins (2 mu g/ml) (from 0.6 +/- 0.4 mN/mm(2), to 1.7 +/- 0.3 mN/mm(2), n=6). These results indicate that signal transduction mediated by G(i) and G(s) proteins may be an important mechanism in the hypoxic vasoconstriction in lamb isolated large pulmonary arteries.

Balbay, Ege Gulec/0000-0002-1557-7019 WOS: 000333867800005 PubMed: 24742035 Introduction and aim. The presented study was undertaken to investigate the respiratory health problems in family barns with one or more cows and at least one family member working in the barn. Methods. 150 workers (128 female, 22 male) from 4 villages of Yigilca district near the city of Duzce in north-west Turkey were enrolled in this study between October December 2011. An Occupational and Environmental Chest Diseases questionnaire developed by the American Thoracic Society, pulmonary function test, physical examination and investigation for nasal eosinophil were performed in all subjects. Results. The mean age of workers was 47.7 +/- 14.2 years. Cough was present in 24% of subjects. The rates of phlegm, wheezing, chest tightness and dyspnea were 13.3%, 6%, 6% and 27.3%, respectively. Obstructive ventilatory pattern was observed in 37 workers (24.6%). 43 workers (28.6%) showed restrictive ventilatory pattern. Nasal eosinophilia was detected in 47.3% (71/150) of the subjects. Pulmonary functions of workers with nasal eosinophilia did not differ from the other workers. There were statistically significant negative correlations between the duration of working in barns and respiratory functions. Conclusions. Pulmonary functions of barn workers have been found to be decreased related to the duration of barn working. Furthermore, respiratory symptoms increased in relation with both barn working and biomass consumption. Precautions should therefore be taken to ventilate both barns and houses.

Balbay, Ege Gulec/0000-0002-1557-7019; POYRAZ, BARIS MUSTAFA/0000-0002-5712-2127 WOS: 000333151200021 PubMed: 24482704 Objective: To evaluate the patients' attitudes about the devices, of which they use for long-term respiratory support at home. Method: 200 consecutive patients were questioned about the treatment and devices of respiratory support at home by face to face questionnaire. Their records were taken from the archives of Social Security Agency. Results: 123 (61.5%) of the patients were men and 77 (38.5%) were women. The mean age was 65.8 +/- 11.9 (15-92) years. The most frequently prescribed device was oxygen concentrator and BIPAP was the one that follows. The most common indications were hypoxic and hypercapnic respiratory failure due to COPD. The devices were prescribed by the state university hospitals, most commonly. The average daily oxygen usage duration was 16.3 +/- 3.1 hours, the average duration was 7.4 +/- 3.1 hours, for BIPAP. Twenty one (11.4%) of the patients, who were treated with LTOT, stated that they were taking oxygen less than 15 hours a day. Higher education levels of the patients was correlated with the higher rates of visiting the companies - that they bought the devices-both for information about and control of the devices (p=0.002). The rate of visiting companies/firms was significantly higher in patients, who use BIPAP and respiratory support combined with it (p=0.010). Twenty three (47.9%) of the 48 patients, who notified that their devices were impaired, waited for repairment by the firm, 20 (41.6%) investigated special repair facilities and the rest (10.5%) rented a new device. Conclusion: Effective and continuous technical maintenance support must be provided to the patients, who are treated with long-term respiratory support at home.

Hipoksik pulmoner vazokonstriksiyon akciğerlerde ventilasyon perfüzyon dengesini sağlayan fizyolojik uyum mekanizmasıdır. Hipoksemi ile seyreden progressif akciğer hastalıklarının patogenezinde önemli rol oynamakla birlikte sağlıklı bireylerde de görülmektedir. Yoğun çalışmalara rağmen, hipoksik pulmoner vazokonstriksiyonun mekanizması henüz bulunamamıştır. G proteinleri vasküler endotel ve düz kas hücrelerinde reseptör aracılıklı sinyal iletimine aracılık ederek vasküler tonusun düzenlenmesinde önemli rol oynayan membrana bağlı protein ailesidir. Biz bu çalışmada, kuzu izole pulmoner arterlerinde izlenen hipoksik vazokonstriksiyonun oluş mekanizmasında Gi ve Gs proteinlerinin rolünü saptamayı amaçladık. Pulmoner arterler yeni kesilmiş kuzuların sol akciğer alt loblarından izole edildi. Arterler Krebs-Henseleit solüsyonu ile dolu olan izole organ banyosuna asıldı ve izometrik kontraksiyonlar bilgisayarlı poligrafi sistemi ile bağlantılı olan izometrik transdüsır yoluyla devamlı olarak kaydedildi. Solüsyon %75 N2 - %20 O2 - %5 CO2 (Normoksik) ve %95 N2 - %5 CO2 (Hipoksik) karışımı içeren gazlar ile havalandırıldı. Organ banyosundaki parsiyel oksijen konsantrasyonu oksijen elektrodu kullanılarak sürekli olarak ölçüldü. Gi ve Gs proteinlerin rolünü araştırmak için kolera ve pertusis toksini kullanıldı. Çalışmada, dinlenme gerimindeki geniş çaplı pulmoner arterlerde hipoksiye bağlı bir gerim artışı izlenmedi ancak hipoksi 3 mM 5-HT ile prekontrakte edilmiş dokularda kontraksiyona (1.7±0.5 mN/mm2, n=10) sebep oldu. Hipoksik vazokonstriksiyon 2 mg/ml kolera toksini ile inkübasyon sonrası inhibe (2.6±0.4 mN/mm2’den 1.0±0.4 mN/mm2’ye kadar, n=6) ve 2 mg/ml pertusis toksini ile inkübasyon sonrası potansiyalize (0.6±0.4 mN/mm2’den 1.7±0.3 mN/mm2’ye kadar, n=6) oldu. Bu sonuçlar Gi ve Gs proteinleri ile ilişkili sinyal iletiminin geniş çaplı kuzu izole pulmoner arterinde gelişen hipoksik vazokonstriksiyonda önemli bir mekanizma olabileceğini gösterdi. Hypoxic pulmonary vasoconstriction (HPV) is an intrapulmonary adaptive mechanism that matches alveolar ventilation to perfusion. However during prolonged alveolar hypoxia HPV occurs with many pulmonary diseases. Despite intensive studies, cellular mechanisms of HPV are still not well defined. G proteins are a family of membrane-associated proteins believed to be involved in the transduction of various signals including the regulation of vascular tonus. In this study, we aimed to determine the contribution of G i and Gs proteins in hypoxic vasoconstriction of lamb isolated pulmonary artery rings. Pulmonary arteries were isolated from left lower lobe of freshly slaughtered lamb. Arteries suspended in an organ bath filled with Krebs-Henseleit solution and isometric contraction recorded continuously via an isometric transducer connected to a computerised polygraphy system. The solution aerated with 75% N2 - 20% O2 - 5% CO2 (normoxic) and 95% N2 - 5% CO2 (hypoxic) pO2 of bathing medium was measured continuosly using an oxygen electrode. Pertussis toxin and cholera toxin were used to investigate the role of Gi and Gs proteins. In the present study, we observed that hypoxia had no effect on resting force in large artery rings, but it caused a further contraction (1.7±0.5 mN/mm2, n=10) in 3 mM 5-HT precontracted pulmonary arteries rings. Hypoxic vasoconstriction was inhibited by preincubation with 2 mg/ml cholera toxins (from 2.6±0.4 mN/mm 2, to 1.0±0.4 mN/mm2, n=6) and potentiated by preincubation with pertussis toxins (2 mg/ml) (from 0.6 ± 0.4 mN/mm2, to 1.7±0.3 mN/mm2, n=6). These results indicate that signal transduction mediated by Gi and Gs proteins may be an important mechanism in the hypoxic vasoconstriction in lamb isolated large pulmonary arteries.

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WOS: 000449650903633 …

Annakkaya, Ali Nihat N/0000-0002-7661-8830; Balbay, Ege Gulec/0000-0002-1557-7019 WOS: 000311265100022 PubMed: 23075730 Background In many studies, obstructive sleep apnea (OSA) has been shown to be an independent risk factor for cardiovascular disease. Conversely, there are few reports establishing possible relation between OSA and venous thromboembolism (VTE). In this study, the aim is to evaluate OSA via polysomnography in patients with pulmonary embolism and drawing the attention of clinicians to the presence of obstructive sleep apnea syndrome (OSAS) may be a risk factor for pulmonary embolism. Methods Fifty consecutive patients who were diagnosed with pulmonary embolism (PE) were evaluated prospectively for OSAS. Polysomnographic examination was conducted on 30 volunteer patients. The frequency of OSAS in PE was determined and PE cases were compared to each other after being divided into two groups based on the presence of a major risk factor. Results The study consisted of a total of 30 patients (14 females and 16 males). In 56.7% of the patients (17/30), OSAS was determined. The percent of cases with moderate and severe OSAS (apnea hipoapnea index >15) was 26.7% (8/30). Patients who had pulmonary thromboembolism (PTE) without any known major VTE risk (n=20), were compared to patients with VTE risk factors (n=10), and significantly higher rates of OSAS were seen (70% and 30% respectively; P=0.045). The mean age of the group with major PE risk factors was lower than the group without major PE risk factors (52 years old and 66 years old, respectively; P=0.015), however, weight was greater in the group with major PE risk factors (88 kg and 81 kg, respectively; P=0.025). By multivariate Logistic regression analysis, in the group without any visible major risk factors, the only independent risk factor for PE was OSAS (P=0.049). Conclusions In patients with PTE, OSA rates were much higher than in the general population. Moreover, the rate for patients with clinically significant moderate and severe OSA was quite high. PTE patients with OSA symptoms (not syndromes) and without known major risk factor should be examined for OSA. There seems to be a relationship between OSA and PTE. However, whether this relationship is a causal relationship or a relationship due to common risk factors or long-term complications of OSA is not clear. Further comprehensive studies on those special topics are needed to clarify these points. Chin Med J 2012;125(20):3712-3718

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Annakkaya, Ali Nihat N/0000-0002-7661-8830 WOS: 000449650900818 …

WOS: 000287819600022, Introduction: To investigate the effects of hazelnut exposure on pulmonary functions in a cross-sectional study on hazelnut processing workers. Materials-methods: One hundred fifty hazelnut workers (137 females and 13 males), and seventy controls (63 females and 7 males) were included. A questionnaire regarding the respiratory symptoms was given to all subjects. Standard pre-shift and post-shift forced expiratory pulmonary functions were obtained from all participitants by spirometry. Furthermore, dust particles were measured according to their sizes. Results: The occurences of common respiratory complaints as cough (8%) and dyspnea (6%) were significantly higher in hazelnut workers than the controls (p=0.009 and p=0.029, respectively). Both of the pre-shift and post-shift spirometric values of hazelnut workers were significantly lower than those of controls. Post-shift FVC (2738.9 +/- 652.2) was significantly lower than pre-shift FVC (2765.8 +/- 634.8) in hazelnut workers (p=0.024). Nine hazelnut (6.0%) workers have shown a decrease of more than 10% in post shift FEV 1 whereas none of the controls have had abnormal decrease in post shift values (p=0.060). Conclusion: A significant deterioration in both restrictive and obstructive pulmonary functions was observed in hazelnut workers. Preventive measures against dusty workplaces should be undertaken to protect the respiratory health of hazelnut workers.

Annakkaya, Ali Nihat N/0000-0002-7661-8830; Balbay, Ege Gulec/0000-0002-1557-7019 WOS: 000297638500005 Background: Working in oncology leads health care personnel (HCP) to feels stress, lack of satisfaction and to have psychological and physical problems and to be unproductive, estranged from job and to experience burnout. Objective: The aim of this study was to determine burnout state and the coping methods in HCP working in oncology. Methods: Interview Form, Maslach Burnout Inventory and Ways of Coping Inventory were administered total 444 HCP. Results: At the result of study HCP scored 1.76 in emotional exhaustion, 1.05 in depersonalization and 2.25 in lack of personal accomplishment [score range: 0-4]. These scores demonstrate that HCP experience moderate level burnout. It was established that HCP utilize mostly search for social support approach (X: 2.04) and they were least frequently found to use submissive approach (X: 0,97) [range: 0-3] in coping with burnout. It was established that, for emotional exhaustion nurses, other HCP who are consider their income inadequate and feel they have excessive work load form a risk group and for depersonalization with high education level, males, physicians, other HCP who are find their income inadequate run higher risk. It was also found that physicians and HCP with higher level of education, HCP who are feel themselves under excessive work load have a higher risk of experiencing lack of personal accomplishment. Conclusion: Our study demonstrated that it was not possible to avoid burnout in oncology clinics. The administrators should rapidly put into effect projects and regulations which may protect personnel from burnout.