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Öğe Alterations in semen parameters of toll collectors working at motorways: does diesel exposure induce detrimental effects on semen?(Wiley, 2008) Güven, Aysel; Kayıkçı, A.; Çam, Kamil; Arbak, Peri; Balbay, Öner Abidin; Çam, MeryemAir pollution is contemporarily considered to be a significant cause in impairing semen parameters. The aim of this study was to investigate possible effects of traffic pollutants, mainly the diesel exposure, on semen analysis. A total of 38 men working as toll collectors at motorways formed the study group. Simultaneously, 35 men working as office personnel constituted the control group. Factors including varicocele, chronic diseases that can affect sperm production were the exclusion criteria. No difference regarding smoking was present between the groups. Usual semen analysis according to WHO guidelines was performed. The results of semen analysis revealed decreased motility and low sperm counts in eight and seven men from the study group respectively. Besides, a man from the same group had combined abnormality of decreased motility and low sperm count. However, two men from the control group had slight motility defect and one had low sperm count. The differences regarding the abnormal sperm count and motility were significant between the groups (P = 0.002 and P = 0.003, respectively). Similarly, the ratio of sperm cells with normal morphology was significantly lower in the study group than that in the control group (P = 0.001). This observation proposes that air pollution particularly diesel exposure may have detrimental effects on sperm parameters.Öğe Anemia and Red Blood Cell Transfusion Practices in a Medical Intensive Care Unit(Soc Turkish Intensivists - Sti, 2022) Akbaş, Türkay; Balbay, Öner AbidinObjective: The study was aimed to describe red blood cell (RBC) transfusion practices in a medical intensive care unit (ICU). Material and Method: This retrospective study involved patients admitted to the ICU between September 2015 and February 2020. A restrictive transfusion strategy was applied during the study period, in which hemoglobin levels were kept between 7.0 and 9.0 g/dL, and the recommended threshold for RBC transfusion was <7 g/dL, except for patients with acute coronary disease, acute cerebrovascular event, heart failure, severe hypoxemia, or undergoing hip fracture surgery, for whom hemoglobin levels were kept at >= 8 g/dL. Results: Six hundred seventeen patients were included in the study (age 70 +/- 16 years, 51.7% male), with a mean hemoglobin level of 11.1 +/- 2.3 g/dL on admission. RBC transfusion was performed on 204 (33.1%) patients, and admission hemoglobin levels were significantly lower in the transfused than the non-transfused patients (9.4 +/- 1.9 vs. 11.9 +/- 2.1 g/dL; p<0.001). An average of 3.5 units per patient was transfused. Transfused patients had high disease severity scores, required high rates of invasive mechanical ventilation, renal replacement therapy and vasopressor use, and had longer ICU and hospital stays. ICU, in-hospital, 28-day, and 90-day mortality rates were significantly high among transfused patients. Logistic regression analysis identified RBC transfusion as an important predictor of 28-day (OR, 2.51; 95% CI, 1.49-4.23, p=0.001) and 90-day (OR, 1.69; 95% CI, 1.25-2.28; p=0.001) mortality. Conclusion: Patients receiving RBC transfusion have high disease severity scores, exhibit low admission hemoglobin levels, require more organ support therapies, and have high mortality rates. The presence of RBC transfusion is a significant predictor of mortality.Öğe Annual Changes in Forced Expiratory Flows in Toll Collectors: Results from a Four Years Observation(Natl Inst Occupational Safety & Health, Japan, 2009) Arbak, Peri Meram; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Bilgin, Cahit; Ozsahin, Sefa LeventDiesel exhaust (DE) has been accused for various health outcomes including exacerbation of asthma, chronic bronchitis. Exposure to DE has long-term effects on lung development in children and reductions in lung function have been reported. The aim of the study was to evaluate the annual changes in forced expiratory flows among toll collectors in Duzce city from 2002 to 2005. Annual FVC, FEV1 and MMF changes in smoker and nonsmoker 58 toll collectors and 37 controls selected among men who worked in the same company as officer have been followed up. No significant changes were seen in expiratory flows among smoker-nonsmoker toll collectors and controls (p>0.05). Annual FVC, FEV1 and MMF changes were not significantly different between smoker and nonsmoker toll collectors. Twelve toll collectors (20.7%) in the study group and 4 (10.8%) controls were found to have FEV1 and FVC below longitudinal lower limit of normal. The difference between groups did not reach statistically significance (p>0.05). Toll collectors (18/58) and controls (15/37) with spirometric measurements for three times showed no difference according to the rate of annual difference in either FEV1 (-21.3 +/- 133.1 ml/yr vs -44.3 +/- 166.6 (ml/yr) or FVC (13.2 +/- 202.9 ml/yr vs. -16.1 +/- 204.2 ml/yr). Further investigations including large groups with long term follow up are needed to observe annual FVC, FEV1 and MMF changes among toll collectors.Öğe Are serum eosinophilic cationic protein levels of toll collectors affected by diesel exhaust exposure?(Professional Medical Publications, 2016) Bilgin, Cahit; Arbak, Peri Meram; Yavuz, Özlem; Balbay, Ege Güleç; Balbay, Öner Abidin; Annakkaya, Ali NihatObjective: There are few studies on the diesel exhaust particulates (DEP) / eosinophilic cationic protein (ECP) level relationship. This study aimed to detect ECP levels in a highly DE exposed group, named as toll collectors. Methods: In a cross-sectional study, levels of serum ECP, rates of respiratory symptoms, mean levels of respiratory functions, smoking status, and variations in peak expiratory flow (PEF) during weekends and working days were compared for 68 toll collectors (TC) (range of age, 24-48 years) and 28 controls (range of age, 25-61 years). All subjects in the study group were men. Results: No significant difference was observed in terms of symptoms and smoking rates between the toll collectors and control group. The number of toll collectors [12/68 (17.7%) vs 1/28 (3.5%)] with diurnal PEF variability in the working period was higher than that of controls (p=0.058). Mean ECP level of toll collectors was higher than that of controls (32.8 vs 21.4 ng/L), but the difference was not significant. Mean ECP levels were higher in subjects experiencing diurnal PEF variability during work and off-work periods (34.9 vs 28.3 ng/L, p=0.410). Conclusions: Serial PEF measurements combined with serum ECP measurements did not add a new tool to detect the sensitivity of workers dealing with DE. Much more diesel exhaust exposed workers should be included to search for cheap and available methods when evaluating airway.Öğe Assessment of the frequency of deep venous thromboembolism in obstructive sleep apnea syndrome(Taylor & Francis Ltd, 2019) Bahar, Yağmur; Annakkaya, Ali Nihat; Şen, Çiğdem; Oktay, Mehtap; Aytekin, Fuat; Balbay, Öner AbidinThe present study aimed to investigate the frequency of deep venous thrombosis (DVT) among patients with obstructive sleep apnea syndrome (OSAS). Patients who referred the preliminary diagnosis of OSAS were included in this study. D-dimer levels of all patients were measured, and D-dimer (+) patients were evaluated by Doppler USG of the lower-extremity. Mean age of the patient group was 52 +/- 12 years and 31.8% (76/239) were women. The rate of D-dimer positivity among severe-OSAS cases (15/85) was significantly higher compared to the rest (13/154) (17.6% and 8.4%, respectively; p = 0.034). The risk of D-dimer positivity was elevated by 2.3 folds in severe-OSAS cases (OR: 2,324, 95% confidence interval: 1.048-5.152). Among 28 D-dimer (+) cases, 4 (14.2%) had DVT as demonstrated by USI of the lower-extremity. All four cases with DVT had severe OSAS. D-dimer was positive in 17.6% (15/85) of all severe OSAS cases. DVT was diagnosed in 4.7% (4/85) of severe-OSAS cases. DVT frequency was 26.6% (4/15) in D-dimer (+) severe-OSAS. Findings of this study indicate that severe-OSAS can be a significant risk factor for DVT. Additionally, data obtained in this study underline the benefits of questioning severe-OSAS patients with respect to DVT symptoms, investigating D-dimer levels and evaluating D-dimer (+) severe-OSAS cases for DVT prophylaxis.Öğe Burnout Status of Health Care Personnel Working in Oncology and their Coping Methods(Drunpp-Sarajevo, 2011) Balbay, Öner Abidin; Işıkhan, Vedat; Balbay, Ege Güleç; Annakkaya, Ali Nihat; Arbak, Peri MeramBackground: 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.Öğe Comparison of Serum CA 19.9, CA 125 and CEA Levels with Severity of Chronic Obstructive Pulmonary Disease(Karger, 2009) Bulut, İsmet; Arbak, Peri Meram; Coşkun, Abdurrahman; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Yavuz, Özlem; Gülcan, ErimObjective: To investigate serum levels of CA 19.9, CA 125 and carcinoembryonic antigen (CEA) in patients with different stages of chronic obstructive pulmonary disease (COPD). Patients and Methods: Fifty-three consecutive patients (50 males, 3 females, mean age 67.6 +/- 10.1 years) with COPD were included in this study. Serum levels of CA 19.9, CA 25 and CEA were determined by the chemiluminescent immunometric method. Based on values obtained from pulmonary function tests, the patients were divided into 3 groups: moderate (21), severe (18) and very severe (14). Data were analyzed with a Kruskal-Wallis one-way analysis of variance test and Mann-Whitney U test. Results: The mean serum levels of CA 125 and CA 19.9 were significantly higher in patients with very severe COPD (p = 0.013 and p = 0.017, respectively) than in patients with severe and moderate COPD (p < 0.05). Patients with cor pulmonale had significantly high mean serum levels of CEA, CA 19.9 and CA 125 (p < 0.05). Patients using a long-acting beta-agonist and theophylline showed significantly higher mean serum levels of CA 125 than patients who were not (p < 0.05). Conclusion: Data showed that the increased serum tumor markers in patients with COPD might be due to the severity of COPD, medication and cor pulmonale. Copyright (c) 2009 S. Karger AG, BaselÖğe Comparison of the tuberculin skin test and the quantiferon test for latent Mycobacterium tuberculosis infections in health care workers in Turkey(Natl Inst Infectious Diseases, 2007) Özdemir, Davut; Annakkaya, Ali Nihat; Tarhan, Gülnur; Şencan, İrfan; Cesur, Salih; Balbay, Öner Abidin; Güçlü, ErtuğrulThe aim of this study was to compare the efficacy of the tuberculin skin test (TST) and the quantiferon test (QFT) for detecting latent tuberculosis infection (LTBI) in health care workers (HCWs). Seventy-six participants who were working in Duzce University Hospital, where tuberculosis patients were being treated, were included in the study. TST was performed according to the Mantoux technique. QFT was performed in accordance with the manufacturer's instructions. A positive TST result was defined as an induration diameter of >= 15 mm. TSTs were positive in 41 of 76 participants (53.9%) and QFT was positive in 65 of 76 participants (85.5%). There was a significant difference between the numbers of QFT-positive and TST-positive cases (P = 0.02). When the induration diameter of TST was >= 20 min, QFT positivity was 100%. Multivariate analysis revealed that there was a significant correlation between the percentage of patients with QFT positivity and the induration diameter of TST (P = 0.009). QFT thus seems to be more effective for LTBI diagnosis than TST. However, large-scale trials including quantitative measurement of QFT in subgroups taking into account the division where HCWs are employed and the different results of TST might clarify the usefulness of QFT in LTBI diagnosis.Öğe THE EFFECT OF NATURAL GAS WARMING ON EMERGENCY APPLICATIONS DUE TO RESPIRATORY TRACT DISEASES IN CHILDREN IN DUZCE CITY(Parlar Scientific Publications (P S P), 2019) Gülhan, Pınar Yıldız; Balbay, Ege Güleç; Annakkaya, Ali Nihat; Balbay, Öner Abidin; Arbak, Peri MeramThe 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<0.0001) increased, rates of stove usage (2014:47%-2017:35.7%, p<0.0001) decreased, annual mean air temperature values (2014:13.9-2017:16.7, p<0.0001) increased significantly. When all pediatric emergency admissions between 2014 and 2017 were examined, the number of those diagnosed with respiratory tract disease reduced while the number of general pediatric emergency admissions increased. The use of more clean fuels for heating purposes was observed to decrease the incidence of acute respiratory tract infections significantly in the preschool and school age group children. The use of clean fuel should be encouraged since preventing childhood infections would protect from the chronic lung diseases that may occur during adulthood.Öğe The effect of particular matter pollution on emergency room visits due to COPD and asthma and the association with hospitalization rate in Duzce City(European Respiratory Soc Journals Ltd, 2012) Balbay, Ege Güleç; Arbak, Peri Meram; Balbay, Öner Abidin; Annakkaya, Ali Nihat…Öğe Effect of symptom-to-treatment interval on prognosis in lung cancer(Sage Publications Ltd, 2007) Annakkaya, All Nihat; Arbak, Peri Meram; Balbay, Öner Abidin; Bilgin, Cahit; Erbaş, Mete; Bulut, İsmetAims and background: To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods: One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results: The patients were followed up for a mean period ( SD) of 7.4 +/- 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 +/- 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 +/- 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-totreatment intervals were 41 +/- 82 days (median, 10) and 16 +/- 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions: The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.Öğe The effects of Two Sequential Earthquakes on Tuberculosis Patients: An Experience from Duzce Earthquake(Drunpp-Sarajevo, 2011) Balbay, Öner Abidin; Balbay, Ege Güleç; Arbak, Peri Meram; Annakkaya, Ali Nihat; Bilgin, CahitSetting: Duzce city, a rural area in the northwest part of Turkey. Objectives: To examine the effects of two sequential earthquakes on sociodemographic and disease related features of tuberculosis (TB) patients. Methods: The present study was conducted among newly diagnosed smear positive (from October 1998 to October 2002) 112 pulmonary TB patients based on a specific questionnaire. Patients were divided into 3 groups regarding the time of diagnosis and the period from the initiation to the end of the treatment (pre, peri and post-earthquake periods). Results: Although the present study has not focused on the factors that influence the adherence of patients to TB therapy, no major changes were observed regarding socio-economical parameters that have an effect on the fate of TB. Patients were frequently hospitalized in pre-earthquake period while patients were ambulatory in peri and post-earthquake period (p<0.005). Patients were significantly controlled once a month in peri-earthquake period (p<0.001). Patients were mostly followed by the same doctor in post-earthquake period. Conclusion: It can be stated that the earthquakes had very little impact on the TB during and after earthquakes in Duzce. Further studies including whole Marmara region are needed to interpret the effect of earthquake on TB control.Öğe Evaluation of tumor markers in asthma patients(2006) Coşkun, Abdurrahman; Balbay, Öner Abidin; Yavuz, Özlem; Memişoğulları, Ramazan; Annakkaya, Ali Nihat; Bulut, İsmet; Kurt, EmelAmaç: Tümör belirteçleri malignitelerin relapsının erken tespitinde ve tedaviye cevabın izlenmesinde biyobelirteçler olarak kullanılmasına rağmen, çoğu tümör belirtecinin kanser tanısında kullanmak için yeterince spesifik olmadığı bilinmektedir. Biz bu çalışmada astımlı hastalarda serum AFP, CEA, CA 19-9, CA 125, CA 15- 3 ve IgE düzeylerini araştırmayı amaçladık. Yöntem ve Gereç: Bu çalışmaya 35 yeni tanı konulmuş astım hastası ve 14 sağlıklı birey dahil edildi. Astımlı ve kontrol bireylerinin antekübital venlerinden kan örnekleri alındı. Otomatik hormon analizöründe, serum AFP, CEA, CA 125, CA 15-3 ve CA 19-9 düzeyleri kemiluminesans, IgE düzeyleri de elektrokemilüminesans immünometrik metodla ölçüldü. Bulgular: Astım hastalarının serum AFP, CEA, CA 125, CA 15-3 ve CA 19-9 düzeyleri kontrol grubundan istatistiksel olarak farklı değildi. Astım hastaları grubunda IgE ile CA 125 arasında negatif (r -0,401; p 0,017) ve CA 125 ile CA 15-3 arasında ise anlamlı pozitif korelasyon olduğu gözlendi (r 0,368; p 0,029). Sonuç: Astım hastalarının serumlarında AFP, CEA, CA 125, CA 19-9 ve CA 15-3 düzeyleri kontrol grubundan farklı olmadığı sonucuna vardık. Astımlı hastalarda bu tümör belirteçlerindeki herhangi bir yükseklikliğin tespit edilmesi durumunda klinisyenlerin, astımdan başka ilave hastalıklarıda göz önünde bulundurmaları gerektiğini düşünmekteyiz.Öğe Hiperkapnik Solunum Yetmezliği Gelişen Kronik Obstrüktif Akciğer Hastalığı Hastalarında Noninvaziv AVAPS (Average Volume Assured Pressure Support) Modu(Duzce Univ, 2018) Balbay, Ege Güleç; Aytekin, Fuat; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Arbak, Peri MeramAmaç: Bu çalışmada, AVAPS (Average Volume Assured Pressure Support) modu ile Noninvazif Mekanik Ventilasyon (NIV) uygulanan hastalarda hasta uyumu ve klinik başarı oranlarının araştırılması amaçlanmıştır. Gereç ve Yöntem: Hiperkapnik Solunum Yetmezliği Gelişen 22 Kronik Obstrüktif Akciğer Hastalığı tanılı hastaya AVAPS modu uygulandı. Başlangıç parametreleri olarak; AVAPS Modunda IPAP Max 20 cm H2O, IPAP Min 12 cm H2O, Hedef Tidal volüm=İdeal kilo x 6 ml/kg, EPAP 5 cm H2O ayarları ile başlanıp hastanın tolere ettiği ölçüde arttırılacak ve SaO2 ≥ %90 olacak şekilde verildi. Hastaların NIV bağlandıktan sonra 1, 2, 8 ve 24. saatlerde arter kan gazı kontrolleri, nabız, solunum sayısı, Borg dispne skalası ölçümleri yapıldı. Bulgular: Çalışmaya dahil edilen yaş ortalaması 70±10 olan 22 hastanın %72,7 (n:16)’si erkekti. Hastaların %59 (n:13)’unda 24 saat içerisinde PH değerleri normal aralığına ulaştı. Hastaların NMV öncesi PH, PCO2, PaO2/FiO2 ve Borg dispne skalası değerler ile NMV uygulamasının 1, 2, 8, 24 saat PH, PCO2, PaO2/FiO2 ve Borg dispne skalası değerleri karşılaştırıldığında istatistiksel anlamlı olarak PH (p<0,001) ve Pa02/FiO2 (p=0,002) değerlerinde artma, PCO2 ve Borg dispne skalası değerlerinde sırasıyla (p<0,001, p<0,001) azalma olduğu görüldü. İzlenen parametrelerinde tümünde 1. Saatte anlamlı değişiklik görüldü. Hiçbir hastada uyumsuzluk izlenmedi. Servis takipleri sonucunda hastaların %95 (n:21)’i evine taburcu edilebildi. Sonuç: AVAPS modu ile NIV uygulanmasında hasta uyumu ve klinik başarı oranlarının yüksek olduğu görüldü.Öğe KOAH'lı istirahat koşullarında ekspiratuar akım hızları ve arter kan gazı değerlerinin egzersiz performansına etkisi(2002) Yazıcı, Mehmet; Arbak, Peri Meram; Balbay, Öner Abidin; Maden, Emin; Erbaş, Mete; Erbilen, Enver; Uyan, CihangirBu çalışmada KOAH'lılarda istirahat koşullarında ekspiratuar akım hızları ve kan gazı değerlerinin yürüme bandında efor testi parametreleri (treadmill exercise testing parametres: TETP) ile ilişkisi ve bunun hastalığın şiddetini öngörmedeki değeri araştırılmıştır. Bu çalışmaya 45 KOAH'lı hasta (kadın/erkek: 9/36, yaş ortalaması: 6111yıl) ve 21 sağlıklı birey (kadın/erkek: 4/17, yaş ortalaması: 6010 yıl) alındı. Tüm KOAH'lı hastalar (I. grup, FEV1 %51.37.2) FEV1 değerlerine göre 3 altgruba (II. grup/hafif KOAH, FEV1 %60-79, III. grup/orta düzeyde KOAH, FEV1 %40-59, IV. grup/ileri derecede KOAH, FEV1 %40 ) ayrıldı. Kontrol grubunda FEV1 %80 idi. Tüm gruplara istirahat koşullarında spirometri ile SFT ve sonrasında semptomla sınırlı maksimum efor testi uygulandı. Toplam koşu süresi (TKS), toplam metabolik eşdeğerleri (TMET), maksimum VO2 ( mVO2) düzeyleri ve maksimum kalp hızı (mKH), III. grup (mV02: 17.64.9; p0.0001, TKS: 3.81.1; p0.0001, TMET: 4.81.3, p0.001, mKH: 127.917.3 p0.01) ve IV. grupta (mVO2: 15.25.3, p0.0001, TKS: 3.31.2, p0.0001, TMET: 3.91.5, p0.0001, mKH: 114.915.6, p0.001) kontrollere (mVO2: 27.35.9, TKS: 7.11.3, TMET: 8.32.2, mKH: 137.313.4) göre anlamlı farklılık göstermekteydi. Ek olarak IV. grupta ventriküler erken atım sayısı (VEAS) kontrol grubuna göre anlamlı olarak artmıştı (2.91.4'e 1.71.1, p0.01). Hafif KOAH grubunun tüm değerleri kontrol grubuna benzerdi. FEV1 ile TETP arasında III. grupta (mVO2: r0.35/p0.005, TKS: r0.31/p0.01, TMET: r0.29/p0.01) ve IV. grupta (mVO2: r0.49/p0.001, TKS: r0.45/p0.005, TMET: r0.31/p0.01, mKH: r0.29/p0.01, VEAS: r0.27/p0.05) anlamlı korelasyonlar saptandı. Ayrıca IV. grupta PaO22 değerleri ile TETP arasında da benzer bir ilişki (mVO2: r0.43/p0.005, TKS: r0.35/p0.01, TMET: r0.32/p0.02, mKH: r0.31/p0.03, VEAS: r-0.29/p0.05) bulundu. Bu çalışmada orta-ileri derecede KOAH'lılarda istirahat ekspiratuar akım hızları ve PaO2 değerleri ile efor testi parametreleri arasında yakın bir ilişki olduğu ve bu ilişkinin hastalığın ciddiyetini öngörmede önemli bir rolü olabileceği sonucuna vardık.Öğe Koroner anjiyografi yapılan hastalarda iohexolün solunum fonksiyon testi parametrelerine etkisi(2004) Akdemir, Ramazan; Özhan, Hakan; Balbay, Öner Abidin; Erbaş, Mete; Gündüz, Hüseyin; Arbak, Peri Meram; Uyan, CihangirAmaç: Damar içine uygulanan anjiyografik kontrast ajanlara bağlı olumsuz yan ekilerin varlığı daha önceki çalışmalarda bildirilmiştir. Bu çalışmanın amacı günlük uygulamada “iohexolün”ün koroner anjiyografi sırasında kullanımına bağlı solunumsal etkilerini incelemektir. Materyal ve Metod: Koroner arter hastalığı ön tanısıyla koroner anjiyografi yapılan 30 hasta çalışmaya alındı. Kronik obstruktif akciğer, bronşiyal astım, miyokard infarktüsü ve ekokardiyografik olarak saptanmış sol ventrikül sistolik disfonksiyonu olan hastalar çalışmaya alınmadı. Koroner anjiyografiden hemen önce ve sonra solunum fonksiyon testi yapıldı ve kan gazı bakıldı. Hastalar anjiyografide koroner arter hastalığı olanlar (Grup1) ve olmayanlar (Grup2) şeklinde ikiye ayrıldı. Koroner anjiyografi işlemi tek deneyimli bir operatör tarafından yapıldı. Protokol gereği hastaların hiç birine sol ventrikülografi yapılmadı. Bulgular:Koroner anjiyografi öncesi ve sonrası sonuçlar karşılaştırıldı. İşlem sonrası bakılan birinci saniye sonu forse orta ekspiryum volüm (FEV1), maksimum mid-ekspiryum akım hızı (MMFR) 25-75, arteriyel oksijen basıncı (PaO2),bikarbonat (HCO3) değerleri tüm hastalarda anlamlı derecede düşük bulundu ( p 0.01). İşlem sonrası bakılan FEV1 ve PaO2 Grup1’de diğer gruplara göre anlamlı derecede daha düşük bulundu ( p 0.01) Sonuç: Bilinen bir akciğer hastalığı olmayan hastalarda iohexol kullanılarak yapılan tanısal koroner anjiyografi, solunum fonksiyon testi parametrelerinde küçük, ama önemli bir bozulmaya yol açmaktadır. Bundan dolayı bilinen akciğer hastalığı olanlarda opak madde kullanımında dikkatli olunması gerekli olduğu sonucuna varıldı.Öğe Kuzu İzole pulmoner arterlerinde gelişen hipoksik pulmoner vazokonstriksiyonda Gi ve Gs proteinlerinin rolü(2014) Erbaş, Mete; Balbay, Öner Abidin; Güleç, Ege Balbay; Uzun, Özge; Sılan, CoşkunHipoksik 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 (1.70.5 mN/mm2, n10) sebep oldu. Hipoksik vazokonstriksiyon 2 mg/ml kolera toksini ile inkübasyon sonrası inhibe (2.60.4 mN/mm2den 1.00.4 mN/mm2ye kadar, n6) ve 2 mg/ml pertusis toksini ile inkübasyon sonrası potansiyalize (0.60.4 mN/mm2den 1.70.3 mN/mm2ye kadar, n6) 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.Öğe Kuzu Jzole Pulmoner Arterlerinde Geli§en Hipoksik Pulmoner Vazokonstríksíyonda Give Gs Proteínierínín Rolü ^^(Kafkas Univ, Veteriner Fakultesi Dergisi, 2014) Erbaş, Mete; Balbay, Öner Abidin; Uzun, Özge; Balbay, Ege Güleç; Sılan, CoşkunHipoksik 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.Öğe Obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma(Hong Kong Acad Medicine Press, 2014) Balbay, Ege Güleç; Balbay, Öner Abidin; Annakkaya, Ali Nihat; Süner, Kezban Özmen; Yüksel, Harun; Tunç, Murat; Arbak, Peri MeramObjective: To investigate the prevalence of obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma. Design: Case series. Setting: School of Medicine, Duzce University, Turkey. Patients: Twenty-one consecutive primary open-angle glaucoma patients (12 females and 9 males) who attended the out-patient clinic of the Department of Ophthalmology between July 2007 and February 2008 were included in this study. All patients underwent polysomnographic examination. Results: The prevalence of obstructive sleep apnoea syndrome was 33.3% in patients with primary open-angle glaucoma; the severity of the condition was mild in 14.3% and moderate in 19.0% of the subjects. The age (P = 0.047) and neck circumference (P = 0.024) in patients with obstructive sleep apnoea syndrome were significantly greater than those without the syndrome. Triceps skinfold thickness in glaucomatous obstructive sleep apnoea syndrome patients reached near significance versus those without the syndrome (P = 0.078). Snoring was observed in all glaucoma cases with obstructive sleep apnoea syndrome. The intra-ocular pressure of patients with primary open-angle glaucoma with obstructive sleep apnoea syndrome was significantly lower than those without obstructive sleep apnoea syndrome (P = 0.006 and P = 0.035 for the right and left eyes, respectively). There was no significant difference in the cup/disc ratio and visual acuity, except visual field defect, between primary open-angle glaucoma patients with and without obstructive sleep apnoea syndrome. Conclusions: Although it does not provide evidence for a cause-effect relationship, high prevalence of obstructive sleep apnoea syndrome in patients with primary open-angle glaucoma in this study suggests the need to explore the long-term results of coincidence, relationship, and cross-interaction of these two common disorders.Öğe Pregnancy-associated plasma protein-A and asthma(Health Communications Inc, 2007) Coşkun, Abdurrahman; Balbay, Öner Abidin; Duran, Sadık; Annakkaya, Ali Nihat; Bulut, İsmet; Yavuz, Özlem; Kurt, EmelPregnancy-associated plasma protein-A (PAPP-A) is potentially a proatherosclerotic metalloproteinase and a new inflammatory marker. Investigators sought to evaluate the significance of PAPP-A in patients with asthma. Blood samples were collected from 35 patients and 20 control subjects. Serum PAPP-A was determined by enzyme-linked immunosorbent assay. PAPP-A levels of patients with asthma (8.1 +/- 5.0 mU/L) were higher than those of the control group (4.9 +/- 2.1 mU/L) (P <.01). A significant correlation was noted between serum PAPP-A concentration and asthma severity (r=.581; P <.01). Investigators concluded that PAPP-A may contribute to airway smooth muscle hyperplasia as an insulin-like growth factor-dependent insulin-like growth factor-binding protein-4 protease in patients with asthma.
