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Öğe Intralober Pulmonary Sequestration with Arterial Supply from Two Different Origins: A Case Report(Medical Tribune Inc, 2012) Erden, Ersin Sukru; Yetim, Tulin Durgun; Balci, Ali; Akcay, Adnan Burak; Hakverdi, Sibel; Demirkose, MesutPulmonary sequestration is a rare anomaly, which does not have a connection with the bronchial system and gets its blood supply, generally, from the aorta or its branches. Anatomically, two different forms were described: intralobar and extralobar. Although 74% of intralobar pulmonary sequestrations get their blood supply from the descending thoracic aorta, they may get their blood supply from different arteries. Furthermore, there is more than one arterial anomaly in 14.8% of cases. We report an intralobar pulmonary sequestration, in which arterial blood supply is from two different origins (Arcus aorta and celiac trunk). To the best of our knowledge, this is the first case in the literature.Öğe Papillary Thyroid Carcinoma with Lung Metastasis Arising from Dyshormonogenetic Goiter: A Case Report(Hindawi Ltd, 2013) Erden, Ersin Sukru; Babayigit, Cenk; Davran, Ramazan; Akin, Mustafa; Karazincir, Sinem; Isaogullari, Nebihe; Demirkose, MesutPrior radiation exposure is the best known risk factor for thyroid cancers, and papillary thyroid carcinoma (PTC) may arise from dyshormonogenetic goiter. A 17-year-old female patient was admitted to the department of chest diseases with respiratory symptoms. The patient had undergone a thyroid surgery for goiter at the age of 9. A bilateral nodular opacity was detected by radiological examination. The histopathologic examination of the specimen obtained from computed tomography guided trucut biopsy was diagnosed as PTC. We present a very rare case of PTC with lung metastasis that had undergone subtotal thyroidectomy due to dyshormonogenetic goiter eight years ago.Öğe WHAT IS THE CLINICAL SIGNIFICANCE OF MIXED APNEA IN PATIENTS WITH OBSTRUCTIVE SLEEP APNEA: A RETROSPECTIVE STUDY(Carbone Editore, 2014) Genc, Sebahat; Tuncel, Ertan; Savas, Nazan; Demirkose, Mesut; Dikmen, NurselAim: Mixed apnea is defined as absent inspiratory effort in the initial portion of apnea, followed by resumption of inspiratory effort in the second portion. However, the pathophysiological and clinical significance of mixed apnea has not been well defined. This study investigated the likely clinical importance of mixed apnea. Materials and methods: Patients diagnosed with severe obstructive sleep apnea (OSA) in polysomnographic studies were enrolled. Those with a mixed-apnea index value of 5/h or higher were grouped as mixed-OSA (Group 1), and those with a mixed-apnea index value below 1/h were grouped as pure-OSA (Group 2). The patients' demographics, symptoms, clinical and polysomnographic findings, and laboratory examination results were reviewed retrospectively. Results: Groups 1 and 2 contained 24 and 42 patients, respectively. The mean age was significantly lower in Group I than those in Group 2 (47.4 +/- 10.4 vs 52.2 +/- 8.3, respectively, p<0.05). The patients in Group I displayed significantly higher apnea / hypopnea index (AHI) values (p <0.001). Sleep duration, arousal index, and duration of apneas were significantly higher in Group 1 (p=0,006, p=0.013, p=0.008, respectively). While minimum oxygen saturation and mean oxygen saturation levels were significantly lower (p<0.001), mean oxygen desaturation percentages were significantly higher in Group 1 than those in Group 2 (p=0,001). Conclusions: These findings suggest that mixed apnea is not just a subtype of obstructive apnea, and OSA with mixed apnea can be referred as a different fenotype of OSAS. Although there are studies about the alterations in neurochemical control of respiration, pathophysiology is not yet clear. So new studies are needed to investigate the underlying pathophysiology and and clinical outcome.Öğe What is the clinical significance of mixed apnea in patients with obstructive sleep apnea: A retrospective study(Acta Medica Mediterranea, 2014) Genc, Sebahat; Tuncel, Ertan; Savas, Nazan; Demirkose, Mesut; Dikmen, NurselAim: Mixed apnea is defined as absent inspiratory effort in the initial portion of apnea, followed by resumption of inspiratory effort in the second portion. However, the pathophysiological and clinical significance of mixed apnea has not been well defined. This study investigated the likely clinical importance of mixed apnea. Materials and methods: Patients diagnosed with severe obstructive sleep apnea (OSA) in polysomnographic studies were enrolled. Those with a mixed-apnea index value of 5/h or higher were grouped as mixed-OSA (Group 1), and those with a mixedapnea index value below 1/h were grouped as pure-OSA (Group 2). The patients' demographics, symptoms, clinical and polysomnographic findings, and laboratory examination results were reviewed retrospectively. Results: Groups 1 and 2 contained 24 and 42 patients, respectively. The mean age was significantly lower in Group 1 than those in Group 2 (47.4±10.4 vs 52.2±8.3, respectively, p<0.05). The patients in Group 1 displayed significantly higher apnea / hypopnea index (AHI) values (p <0.001). Sleep duration, arousal index, and duration of apneas were significantly higher in Group 1 (p=0,006, p=0.013, p=0.008, respectively). While minimum oxygen saturation and mean oxygen saturation levels were significantly lower (p<0.001), mean oxygen desaturation percentages were significantly higher in Group 1 than those in Group 2 (p=0,001). Conclusions: These findings suggest that mixed apnea is not just a subtype of obstructive apnea, and OSA with mixed apnea can be referred as a different fenotype of OSAS. Although there are studies about the alterations in neurochemical control of respiration, pathophysiology is not yet clear. So new studies are needed to investigate the underlying pathophysiology and and clinical outcome.
