Browsing by Author "Yilmaz H."
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Item Changes in pattern reversal evoked potentials during menstrual cycle(1998) Yilmaz H.; Erkin E.F.; Mavioǧlu H.; Sungurtekin Ü.Hormonal changes that occur during the menstrual cycle of women influence the visual function of femmes Estrogen is reported to cause a decrease in the visual transmission time by increasing the sensitivity of receptors in the optic pathways to dopamine. The aim of this study was to search if pattern reversal evoked potentials (PRVEPs) changed during the different phases of the menstrual cycle. PRVEPs of both eyes of 30 healthy women were recorded in 4 different phases of the menstrual cycle, namely, menstrual, follicular, ovulatory and luteal. The highest mean PRVEP latency and the lowest mean P(100) amplitude were recorded during the menstrual phase. The mean PRVEP latency recorded during the ovulatory phase (when estrogen level rises to 3-5 times that of other phases' without an increase in progesterone levels) was statistically significantly shorter than that of other phases' (p < 0.05). Although not statistically significant, the mean P(100) amplitude recorded during the ovulatory phase was higher than the other phases. Looking at these results, sex steroids seemed to affect the generation of PRVEPs. The significant decrease in PRVEP latencies when estrogen levels peaked was thought to be due to facilitating effect of estrogen on the neural transmission of the visual pathways.Item Visual evoked potentials in pregnancy(1999) Yilmaz H.; Erkin E.F.; Mavioglu H.; Sungurtekin Ü.Pregnancy is a period when the estrogen/progesterone ratio rises considerably because of the passage of estrogen from the placenta. These changes in the level of estrogen during pregnancy increase the sensitivity of the central nervous system to cathecholamines. As a result, the sensitivity of the receptors in both the visual cortex and the inner plexiform layer of the retina to dopamine increases, and transmission in the optic pathways becomes faster. Inspired by this knowledge, we studied monocular pattern-reversal visual evoked potentials (PRVEPs) in both eyes of 30 pregnant women in the first trimester and 30 healthy nonpregnant women in the reproductive age. Mean P100 latency of pregnant women was significantly shorter than mean P100 latency of nonpregnant women (p<0.001). Mean P100 amplitude values were higher in pregnant women, although not statistically significant (p>0.05). Plasma estrogen and progesterone levels of pregnant women showed a negative correlation with PRVEP latencies, but a positive correlation with PRVEP amplitudes. In conclusion, this study supports the impression that changes in the levels of sex steroids affect the formation of PRVEPs by their actions on the central nervous system. The increase in estrogen during pregnancy seems to facilitate neural transmission in the optic pathways. Rise in the estrogen-progesterone level might be responsible for the shorter PRVEPs latencies in pregnant women.Item Effects of oestrogen replacement therapy on pattern reversal visual evoked potentials(2000) Yilmaz H.; Erkin E.; Mavioglu H.; Laçin S.As a result of a regression in the ovarian functions, oestrogen level in circulation during the menopause drops to 1/50 of its value in the normal reproductive cycle. Excitatory oestrogen increases the sensitivity of the central nervous system to catecholamines by changing the opening frequency of voltage-related L-type calcium channels and augmenting the effect of glutamate; in addition it inhibits the formation of gamma-amino butyric acid (GABA) by the inhibition of glutamate decarboxylase enzyme. It is argued that oestrogen increases transmission in the optic pathways and that oestrogen is responsible for the shorter latency values and higher amplitudes of visual evoked potentials in women. We recorded the monocular pattern reversal visual evoked potentials (PRVEP) of both eyes of 54 post-menopausal women before treatment and of 30 of them after replacement therapy with Tibolon, and of 24 women receiving placebo treatment. The explicit values of P100 latency of right and left eyes before treatment were 98.8 ± 3.5 and 99.0 ± 3.3 ms, respectively. The explicit values of P100 latency of right and left eyes after placebo treatment were 98.6 ± 3.7 and 98.8 ± 4.0, respectively. The explicit values of P100 latency of right and left eyes after replacement treatment were 94.6 ± 3.7 and 94.8 ± 4.0, respectively. We found a statistically significant decrease in the mean PRVEP latencies and a statistically significant increase in mean amplitudes after replacement treatment (P < 0.001) compared with those before treatment and those after placebo treatment. We attributed the changes in PRVEP values after replacement treatment to the action of Tibolon, which acted as a natural sex steroid and speeded the visual transmission time via the widespread receptors in the central nervous system. It is concluded that PRVEP is an objective electrophysiological assessment method in evaluating the efficiency of hormone replacement therapy in post-menopausal women.Item Opening the cardiac chambers does not make any difference in P300 measurement(2006) Iskesen I.; Yilmaz H.; Yildirim F.; Selcuki D.Objective. Cognitive brain dysfunction after open heart surgery is a serious complication caused by cardiopulmonary bypass (CPB). The presence of gaseous and/or particulate emboli in the CPB circuit and cerebral hypoperfusion may be the causes of neurologic problems after cardiac operations. Methods. In this prospective study we examined 42 consecutive cardiac surgery patients (24 mitral valve replacement [MVR] and 18 coronary artery bypass grafting [CABG] patients). In addition to determination of clinical measurements, cognitive brain function was measured objectively by P300 auditory-evoked potentials before operation, at day 7, and at 4-month follow-up. Electroencephalographic evaluations were also performed. Results. In preoperative measures there was no difference between the groups (peak latencies in the MVR group were 324 ± 8 milliseconds; CABG group, 318 ± 6 milliseconds; P > .05). At day 7, cognitive P300 auditory-evoked potentials were significantly impaired (prolonged) in both groups compared to preoperative values (MVR group, 347 ± 7 milliseconds; CABG group, 342 ± 7 milliseconds; P < .05). P300 measurements almost returned to normal at 4-month follow-up (MVR group, 331 ± 6 milliseconds; CABG group, 319 ± 8 milliseconds; P > .05 compared to preoperative values). One week and 4 months after surgery no difference between the 2 groups could be found (P > .05). Conclusion. Postoperative patients had prolonged P300 values according to the preoperative measurements and we have not found any difference between the groups whether cardiac chambers were opened or not. © 2006 Forum Multimedia Publishing, LLC.Item Prevalence of pseudoneurologic conversion disorder in an urban community in Manisa, Turkey(2007) Deveci A.; Taskin O.; Dinc G.; Yilmaz H.; Demet M.M.; Erbay-Dundar P.; Kaya E.; Ozmen E.Background: There is not a wide agreement upon rate of conversion disorder within Turkish population. The aim of this study was to determine the prevalence of conversion disorder with pseudoneurological symptoms or deficits and related risk factors in a city. Method: In total, 1,086 people, aged 15-65 years old, were selected from the city of Manisa, Turkey to take part in the study. We applied sociodemographic and health information questionnaires and the Composite International Diagnostic Interview (CIDI) Somatization Subscales to the samples. Results: The likelihood that an individual might have conversion disorder with pseudoneurological symptoms or deficits was found to be 5.6% (n = 61). The prevalence of conversion disorder with pseudoneurological symptoms or deficits was significantly higher among women (p < 0.0001), 15-24 year old women (p = 0.011) and 25-34 year old women (p = 0.003), people who live as squatters (p = 0.03), those with a history of psychiatric disorder (p < 0.0001) and those having a mother with a psychiatric disorder (p = 0.04). Conclusion: This study has shown the conversion disorder with pseudoneurological symptoms or deficits is inadequately frequent in the population. © Springer-Verlag 2007.Item Follow-up with objective and subjective tests of the sleep characteristics of patients after cardiac surgery(2007) Yilmaz H.; Iskesen I.Background: The purpose of this study was to investigate the changes in sleep characteristics in patients who underwent coronary artery bypass grafting (CABG) surgery, using both subjective and objective tests in the early (preoperative) and late (postoperative) periods. Methods and Results: Forty-five patients who underwent CABG and did not previously have any sleep disturbance were evaluated by subjective and objective sleep parameters during a consecutive 3-5-day preoperative examination, during a consecutive 5-8-day period in the 1st postoperative week, and during consecutive 5-8-day periods in the 1st and 2nd postoperative months. The Pittsburgh Index and Epworth Sleepiness Scale values, sleep latency, napping episodes, total napping period, duration of wakefulness after sleep onset and fragmentation index values were significantly increased; however, Maintenance of Wakefulness Test lengths, total sleep time and sleep efficiency were significantly decreased in the 1st postoperative week. All of these were the same in the 1st postoperative month and differences were not statistically different from the preoperative period. None of the sleep parameters in the 2nd postoperative month differed from the values obtained in the preoperative period. Conclusion: The cause of sleeplessness after CABG surgery may be temporary deterioration of circulation in the centers of the brain stem and hypothalamus that control sleep and awakening. Improvement of the circulation in these centers a few months after the operation helps to regain sleep control, and thus sleep disturbances disappear.Item Late daytime naps may cause drowsiness after coronary bypass graft operation in the first postoperative week(2007) Yilmaz H.; Iskesen I.[No abstract available]Item Objective and subjective characteristics of sleep after coronary artery bypass graft surgery in the early period: A prospective study with healthy subjects(2007) Yilmaz H.; Iskesen I.Background. The purpose of this study was to investigate changes in sleep characteristics by examining both subjective tests and objective parameters such as actigraphic sleep analysis in patients who underwent coronary artery bypass graft surgery (CABG). Patients and Methods. Forty-five patients who underwent CABG operations and did not have any sleep disturbance were examined. They were evaluated by subjective and objective sleep parameters at the beginning of the examination and on the fifth postoperative day. Forty healthy subjects who did not undergo the operation were also evaluated. Results. The Pittsburgh Index and Epworth values in the postoperative group were significantly higher, but Maintenance of Wakefulness Test lengths were significantly shorter than in the preoperative and control groups. Sleep latency, napping episodes, total napping periods, and fragmentation index values of the postoperative group were significantly higher, but sleep efficiency values were significantly lower than in the preoperative and control groups. Conclusion. The cause of sleeplessness after CABG surgery may be the temporary deterioration of circulation in the centers of the brain stem and hypothalamus, which control sleep and awakening. It can be proposed that the improvement of the circulation in these centers a couple of months after the operation help to regain sleep control, and thus sleep disturbances disappear. © 2006 Forum Multimedia Publishing, LLC.Item Comparison of motor activity and sleep in patients with complex partial seizures on levetiracetam treatment and a group of healthy subjects(Hindawi Limited, 2007) Yilmaz H.Purpose: Levetiracetam-treated patients commonly report daytime drowsiness, fatique, asthenia and decreasing of motor activity. However the origin of these reported side effects are still debated, we aimed to clarify effect of levetiracetam on sleep. Therefore this prospective study was conducted to evaluate the effects of levetiracetam on motor activity, amount and continuity of sleep and napping. Methods: Various tests were performed on twenty two patients treated with levetiracetam (10 monotherapy, 12 add-on therapy) at least three days before the initiation of treatment, and consecutively for five to eight days at the third week of treatment. These tests included sleep logs, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Modified Maintenance of Wakefulness Test and actimetric measurements. In order to evaluate the sleep behavior of these patients the following sleep parameters were estimated: bedtime, wake-up time, sleep-onset time, sleep-offset time, sleep latency, total sleep time, wake time after sleep onset, fragmentation index, total activity score, nap episodes, total nap duration and sleep efficiency. Twenty members of staff from our hospital (Doctor, nurse, secretary, civil servant etc.) were evaluated as control subjects in the study. Results: After three-week treatment with levetiracetam (in particular with add-on therapy), Epworth Sleepiness Scale scores, napping episodes and total nap durations increased and sleep latencies decreased. While durations of Modified Maintenance of Wakefulness Test and total activity scores decreased. However the total sleep time and the sleep efficiency did not show any difference from the pre-treatment values. Conclusions: Our results suggest that levetiracetam leads to drowsiness by decreasing the daily motor activity and increasing the naps; however this agent does not have any major effects on total sleep time and sleep efficiency during night. Actimetric analyses give information about continuity of sleep and sleep/wake states however does not give satisfactory information about architecture of sleep. In order to determine the effects of levetiracetam on the sleep architecture we need similiar protocol studies by full night polysomnography. © 2007 - IOS Press and the authors. All rights reserved.Item A descriptive study: Psychiatric diseases accompanying obstructive sleep apnea syndrome (OSAS); [Tanimlayici bir çalişma: Obstrüktif uyku apne sendromuna (OSAS) eşlik eden psikiyatrik hastaliklar](2008) Bakar E.E.; Yilmaz H.Purpose: OSAS is a disease which involves a wide range of symptoms from simple snoring extending up to the tables accompanied by serious cardiovascular, pulmonary, endocrine and psychiatric diseases. In our study; we aimed to look into the variety of the psychiatric diseases observed in patients with diagnosis of OSAS and to discuss the spectrum of psychiatric diseases accompanied by the typical clinical symptoms and findings in light of literature. Methods: The cases who visited our outpatient clinic in between 2004-2007 and reveived preliminary diagnosis of OSAS were inspected all night through video-EEG-polysomnography by certificated sleep technicians using devices of Embla A-10, N-7000Ë in accordance with sleep apnea protocol in order to trace the change in sleep structure and breathing events. All the cases were assessed by a psychiatric expert and those who had the diagnosis of psychiatric disease according to the criteria of DSM IV were included in the study. Results: Of 235 cases, in 23.8%, there found to have at least one comorbid psychiatric disease. In these cases, the frequency of the depression was 92.8%, schizophrenia was 7.1%, OCD (obsessive compulsive disorder) was 3.5%, and bipolar disorder - depressive episode was 1.7%. OSAS and the sleep structure of the cases having psychiatric disorders were investigated. AHI (Apnea-hypopnea index) increased in 68% of the cases. Discussion: The sleep continuity in OSAS gets broken and is fragmental. The superficial sleep duration increases, deep sleep and REM sleep get suppressed. In such psychiatric diseases as depression difficulty in falling asleep, destruction in sleep integrity due to the frequent wake-ups are observed. In generalized anxiety disorder and schizophrenia, a fragmental sleep and decrease in sleep efficiency are observed. When the psychiatric disease is accompanied by OSAS, high rate of AHI are frequently encountered. Conclusion: Our study examines the variety of the psychiatric diseases observed in patients with diagnosis of OSAS and makes discussions in light of the psychiatric disease spectrum literature data accompanying the OSAS clinic. Similar studies in bigger serials will ensure the psychiatric disease spectrum seen in cases with OSAS to be understood and diversities in approach against these cases to get clarified.Item Effect of CPAP therapy on catathrenia and OSA: A case report and review of the literature(2008) Songu M.; Yilmaz H.; Yuceturk A.V.; Gunhan K.; Ince A.; Bayturan O.Introduction: Catathrenia is a rare, idiopathic, sleep-related respiratory condition characterized by irregular groans, which occur during prolonged expiration in sleep. The origins of catathrenia remain inexplicable, the long-term prognosis unexplained. Moreover, empirical treatment with neither pharmacological nor non-pharmacological approaches was satisfactory. Case report: We report a case of catathrenia with concurrent obstructive sleep apnea complicated with pulmonary hypertension and reviewed the literature. Discussion: Treatment with nasal continuous positive airway pressure resulted in marked improvement of catathrenia, obstructive sleep apnea, daytime dyspnea, and pulmonary hypertension for our patient. We think that nasal continuous positive airway pressure can be an option for the treatment of this infrequent but sometimes very disturbing sleep disorder. © Springer-Verlag 2008.Item Sleep actigraphy evidence of improved sleep after treatment of allergic rhinitis(American College of Allergy, Asthma and Immunology, 2009) Yuksel H.; Sogut A.; Yilmaz H.; Yilmaz O.; Dinc G.Background: Children with allergic rhinitis (AR) are reported to have disturbed sleep and daytime fatigue due to nasal obstruction. Objective: To evaluate sleep impairment in children with AR using actigraphic evaluation. Methods: Fourteen children aged 7 to 16 years with grass pollen-sensitized seasonal AR were enrolled. They completed the Total 4-Symptom Score (T4SS) scoring system for AR symptom score and the Pittsburgh Sleep Quality Index (PSQI) questionnaire for sleep quality, and they underwent actigraphy for 3 days in the pretreatment period. After topical corticosteroid and antihistaminic treatment for 8 weeks, actigraphy, the T4SS, and the PSQI were repeated. Fourteen healthy children aged 8 to 16 years underwent actigraphy and completed the PSQI questionnaire as controls. Results: There were no significant age or sex differences between the AR and control groups. Pretreatment PSQI and actigraphy scores were worse in the AR group vs the control group. After treatment, sleep quality improved, and there were no differences in actigraphy and PSQI scores between the 2 groups. Before treatment, the T4SS was significantly correlated with the sleep efficiency, daytime napping episodes, and total nap duration variables of actigraphy (r = -0.53, P = .004; r = 0.43, P = .02; and r = 0.39, P = .04, respectively). The T4SS was correlated with the total PSQI score (r = 0.67, P < .001). Conclusions: Sleep can be compromised in children with AR. There is a significant correlation of clinical symptom score with the actigraphic and PSQI variables. Therefore, actigraphy may be used as an objective tool to evaluate sleep disturbance in children with AR.Item Sleep disturbances after cardiac surgery with or without elevated S100B levels(2009) Iskesen I.; Kurdal A.T.; Yilmaz H.; Cerrahoglu M.; Sirin B.H.Objective - The aim of the study was to investigate sleep disturbances of cardiac surgery patients with or without elevated S100B levels. Methods and results - Twenty-two patients with serum S100B > 0.3 μg/l (study group) 12 hours after cardiac surgery with cardiopulmonary bypass and 23 patients with serum S100B < 0.3 (control group) were investigated in a prospective study. They were evaluated with the use of objective sleep tests. Cardiopulmonary bypass has negatively affected the sleep characteristics in the postoperative period for both groups. Maintenance wakefulness test, total sleep time, total activity score and sleep efficiency scores were significantly shorter in the study group in the postoperative period. Sleep latency, percentage of wakefulness after sleep onset, daytime napping episodes and total nap duration in the same period were significantly higher than in the control group. Conclusion - Cardiac surgery affects a patient's sleep characteristics. Patients with elevated S100B values have more sleep disturbances after cardiac surgery than patients with normal S100B values.Item Evaluating sleep characteristics in intensive care unit and non-intensive care unit physicians(Australian Society of Anaesthetists, 2011) Ok G.; Yilmaz H.; Tok D.; Erbüyün K.; Çoban S.; Dinç G.Healthcare workers' cognitive performances and alertness are highly vulnerable to sleep loss and circadian rhythms. The purpose of this study was to investigate the changes in sleep characteristics of intensive care unit (ICU) and non-ICU physicians. Actigraphic sleep parameters, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Hamilton Depression Rating Scale were evaluated for ICU and non-ICU physicians on the day before shift-work and on three consecutive days after shift-work. Total sleep time, sleep latency, wakefulness after sleep onset, total activity score, movement fragmentation index, sleep efficiency, daytime naps and total nap duration were also calculated by actigraph. In the ICU physicians, the mean Pittsburgh Sleep Quality Index score was significantly higher than the non-ICU physicians (P=0.001), however mean Epworth Sleepiness Scale scores were not found significantly different between the two groups. None of the scores for objective sleep parameters were statistically different between the groups when evaluated before and after shift-work (P >0.05). However in both ICU and non-ICU physicians, sleep latency was observed to be decreased within the three consecutive-day period after shift-work with respect to basal values (P <0.001). Total sleep time, total activity score and sleep efficiency scores prior to shift-work were significantly different from shift-work and the three consecutive-days after shift-work, in both groups. Working in the ICU does not have an impact on objective sleep characteristics of physicians in this study. Large cohort studies are required to determine long-term health concerns of shift-working physicians.Item Evaluation of fatty-acid composition of five migratory fish species captured from the Beymelek Lagoon (Turkey) at the end of the feeding period(Springer Science and Business Media, LLC, 2011) Uysal K.; Emre Y.; Yilmaz H.; Donmez M.; Seckin A.K.; Bulbul M.[No abstract available]Item Association between idiopathic generalized epilepsy and EFHC1 gene mutations of 662 G>A and 685 T>C; [İdiyopatik Jeneralize Epilepsi ile EFHC1 Genindeki 662 G>A ve 685 T>C Mutasyonu Arasındaki İlişkinin Araştırılması](Turkiye Klinikleri, 2012) Büyük I.; Tuǧrul B.; Yilmaz H.; Onur E.; Vatandaş G.; Doǧan BozyIǧIt F.Objective: Idiopathic generalized epilepsy (IGE) is an epilepsy form without an underlying brain lesion or neurological indication or symptom. Recent investigations on the genetic origins of IGE and its subtypes report that certain mutations of various ion and non-ion channel genes in the central nervous system may be associated with IGE. Among these mutations, the ones related to the non-ionic channel gene EFHC1 are controversial (545G>A, 685T>C, 628G>A 757G>T, 229C>A, 662G>A, 520A>G, 776G>A, 829C>T). In this study we investigated the relationship between IGE and 662G>A (R221H) and 685T>C (F229L) mutations in EFHC1 gene in a Turkish population. Material and Methods: The study enrolled 96 healthy volunteers (47 male, 49 female) and 96 IGE patients (41 male, 55 female). IGE diagnosis was confirmed in the neurology department. After venous blood sampling, DNA extractions were performed. The presence of 662G>A (R221H) and 685T>C (F229L) mutations in the exon 4 of EFHC1 gene were analyzed using Real-Time polymerase chain reaction (PCR) (Cobas, Roche Diagnostics, Germany). The results of the control and patient groups were compared statistically. Results: In the patient group there was one heterozygous male with 685T>C mutation. In the control group, there were two subjects with 685T>C mutation; one heterozygous male and one heterozygous female. The control and the patient groups did not have the 662G>A mutation. The difference between the patient and the control groups were not significant (p value for 685 T>C mutation=0.56062; p value for 662G>A mutation=1.00). Conclusion: We found no evidence that EFHC1 is a major genetic factor for the development of IGE in Turkish patients. Our results indicated that 685T>C and 662G>A mutations might not be associated with IJE. © 2012 by Türkiye Klinikleri.Item Prevalence and associated factors of sleep-disordered breathing in the Turkish adult population(2013) Ardic S.; Demir A.U.; Ucar Z.Z.; Firat H.; Itil O.; Karadeniz D.; Aksu M.; Sevim S.; Yilmaz H.; Oktay B.Sleep disordered breathing (SDB) represents a major public health problem. We investigated the risk of SDB and associated factors in the Turkish adult population. We collected data by an interviewer-administered questionnaire in a nationwide representative sample of 5021 adults (2598 women, 2423 men) with a mean age of 40.7 years (SD:15.1) in 2010. High risk of SDB was defined as the positive response to at least two of the three categories in the Berlin questionnaire (BQ). High risk of SDB was found in 13.7% (men: 11.1%, women: 20.2%). High risk of SDB prevalence was not significantly different between the genders in the analysis stratified for BMI categories. Female gender, older age, lower level of education and smoking in the past were associated with high risk of SDB in the logistic regression analysis models adjusting for age and gender. After the adjustment for age, gender, smoking, BMI and educational status, high risk of SDB, and BQ Category 2 score were associated with previous hospitalization and cardiovascular diseases. Risk due to BQ Category 1 and BQ Category 2 was more than additive in the models for hypertension and heart disease for the age groups 45-65 years and 65 years and over. Higher prevalence of SDB and obesity among women in our population should be addressed in further studies. Association between high risk of SDB and cardiovascular diseases, if confirmed, indicates the public health importance of screening for SDB symptoms. © 2012 The Authors. Sleep and Biological Rhythms © 2012 Japanese Society of Sleep Research.Item Identification of the variations in the CPT1B and CHKB genes along with the HLA-DQB1*06:02 allele in Turkish narcolepsy patients and healthy persons(Mary Ann Liebert Inc., 2014) Cingoz S.; Agilkaya S.; Oztura I.; Eroglu S.; Karadeniz D.; Evlice A.; Altungoz O.; Yilmaz H.; Baklan B.Background: The HLA-DQB1*06:02 allele across all ethnic groups and the rs5770917 variation between CPT1B and CHKB genes in Japanese and Koreans are common genetic susceptibility factors for narcolepsy. This comprehensive genetic study sought to assess variations in CHKB and CPT1B susceptibility genes and HLA-DQB1*06:02 allele status in Turkish patients with narcolepsy and healthy persons. Methods: CHKB/CPT1B genes were sequenced in patients with narcolepsy (n=37) and healthy persons (n=100) to detect variations. The HLA-DQB1*06:02 allele status was determined by sequence specific polymerase chain reaction. Results: The HLA-DQB1*06:02 allele was significantly more frequent in narcoleptic patients than in healthy persons (p=2×10-7) and in patients with narcolepsy and cataplexy than in those without (p=0.018). The mean of the multiple sleep latency test, sleep-onset rapid eye movement periods, and frequency of sleep paralysis significantly differed in the HLA-DQB1*06:02-positive patients. rs5770917, rs5770911, rs2269381, and rs2269382 were detected together as a haplotype in three patients and 11 healthy persons. In addition to this haplotype, the indel variation (rs144647670) was detected in the 5′ upstream region of the human CHKB gene in the patients and healthy persons carrying four variants together. Conclusion: This study identified a novel haplotype consisting of the indel variation, which had not been detected in previous studies in Japanese and Korean populations, and observed four single-nucleotide polymorphisms in CHKB/CPT1B. The study confirmed the association of the HLA-DQB1*06:02 allele with narcolepsy and cataplexy susceptibility. The findings suggest that the presence of HLA-DQB1*06:02 may be a predictor of cataplexy in narcoleptic patients and could therefore be used as an additional diagnostic marker alongside hypocretin. © 2014 Mary Ann Liebert, Inc.Item Body mass index and sexual dysfunction in males and females in a population study; [Bir populasyon çali{dotless}şmasi{dotless}nda kadi{dotless}n ve erkeklerde vücut kitle indeksi ve cinsel işlev bozukluklari{dotless}](Cukurova Univ Tip Fakultesi Psikiyatri Anabilim Dali, 2014) Karadag H.; Oner O.; Karaoglan A.; Orsel S.; Demir A.U.; Firat H.; Karadeniz D.; Aksu M.; Ardic S.; Ucar Z.Z.; Sevim S.; Yilmaz H.; Itil O.The association of obesity with sexual dysfunctions is complex and far from clear. Most former studies consisted of small samples and did not control several possible confounding factors. Our aim was to investigate the association of BMI with current sexual dysfunction in males and females in a nationally representative population sample after controlling for age, the presence of cardiovascular disorders, diabetes, hypertension, thyroid diseases, anxiety and depression and also menopause in women. The sample included a total of 4162 subjects (2081 females and 2081males). The most frequent sexual problem was premature ejaculation (8.8%) in males and hypoactive sexual desire disorder (13.9%) in females. Univariate analysis showed that hypoactive sexual desire and erectile dysfunction in males and hypoactive sexual desire, lack of pleasure from sexuality and sexual pain in females were associated with obesity. Multivariate analysis indicated that age was significantly associated with almost all types of sexual problems in both sexes. The risks of having no active sexual life, hypoactive sexual desire, lack of pleasure from sexuality and erectile dysfunction were higher in males with diabetes mellitus. Depression and anxiety were associated with all types of sexual problems in females and with no active sexual life, hypoactive sexual desire, erectile dysfunction and premature ejaculation in men. In both sexes BMI was not associated with sexual problems after the confounding factors were controlled. The association of obesity with sexual dysfunction might be mediated by other factors.Item The effect of long term continuous positive airway pressure treatment on systolic and diastolic function in patients with obstructive sleep apnoea syndrome: A five year observational study; [Obstrüktif uyku apne sendromlu hastalarda CPAP tedavisinin sistolik ve diyastolik sol ventrikül fonksiyonlari{dotless} üzerine etkisi; beş yi{dotless}lli{dotless}k takip çali{dotless}şmasi{dotless}](AVES Ibrahim Kara, 2014) Bilge A.R.; Yavuz V.; Çetin N.; Dalgiç O.; Kum G.; Yilmaz H.; Tikiz H.Objective: Evaluation of the long term effects of continuous positive airway presure (CPAP) on mean heart rate and left ventricular systolic and diastolic parameters in obstructive sleep apnea syndrome (OSAS) using conventional and tissue Doppler techniques. Methods: This prospective cohort study is designed to evaluate the long term effects of CPAP treatments in normotensive OSAS patients. Initially 40 patients aged from eighteen to fifty five with documented OSAS syndrome were evaluated within one month of CPAP treatment. All had high self-reported compliance with treatment. From the latter, 21 patients with uninterrupted CPAP therapy (for at least 5 years, 5 hours per day) were included in the study and further evaluated with treatment. The left ventricular systolic function was assessed on apical four- chamber view using modified Simpson method and diastolic function was evaluated with classic transmitral pulsed and tissue Doppler techniques. Paired t test and Wilcoxon signed rank test had been used to compare the clinical and echocardiography data before and after treatment period. Results: A comparison of values assessed after one month and after 5 years of CPAP therapy, revealed a significant increase in the acceleration time(AT) Em/Am ratio and ejection time (ET) (AT: p=0.04; Em/Am ratio p=0.03 ET: p=0.04) while a significant decrease was observed on deceleration time (DT), isovolumetric relaxation time (IRT), myocardial performance index (MPI), mitral regurgitation (MR) and 24 hour mean heart rate (HR) in all subjects (DT: p=0.02; IVRT: p=0,04; MPI: p=0,01; MR: p≤0.001; HR: p=0.004). Conclusion: We observed a significant improvement in the left ventricular systolic and diastolic function and a significant decrease of 24-hour heart rate and mitral regurgitation with unchanged ejection fraction of the left ventricle with long term CPAP treatment similar to short-term treatment studies. The long term maintenance of the beneficial effect of CPAP throughout the 5 year long term treatment can be one of the pathophysiologic mechanisms that may explain the decrease of cardiovascular mortality observed with long term CPAP therapy in OSAS patients. © 2014 by Turkish Society of Cardiology.