Introduction Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, ... more Introduction Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, inflammation, axonal/neuronal loss and gliosis of white matter of central nervous system (CNS) with multifactorial etiology including genetic, environmental and immunological factors [1]. Optic neuritis is a common pathology that may affect nearly half of the patients with MS and also may lead to thinning of the retinal nerve fiber layer (RNFL) due to the neuroinflammation of the optic nerve (2). Spain et al (3) reported that RNLF measured by optical coherence tomography (OCT) may be correlated with disease duration and EDSS scores in patients with untreated MS. In another study RNLF was found to discriminate patients with sub types of MS including clinically isolated syndrome patients; relapsing remitting MS patients; secondary progressive MS (4).
As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of t... more As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of this study was to assess some inflammatory markers in MS patients and their relationships with clinical subgroups and disability status.
By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSA... more By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSAS) and those from patients with simple snoring, we aimed to establish whether OSAS negatively influences cognition. Patients with mild-to-severe OSAS (n ¼ 29) and nonhypoxic simple-snoring patients (n ¼ 30) were admitted to the study. All participants in both groups were evaluated with polysomnography and neurocognitive tests, including the Stroop Test, Rey Auditory Verbal Learning Test, Judgment of Line Orientation, Trail-Making Test, and Symbol Digit Modalities Test (SDMT). Significant differences were identified between the groups for test scores on the Rey 1, SDMT, and Stroop tests. We propose that accurate OSAS diagnosis and treatment might help to prevent cognitive decline.
JPMA. The Journal of the Pakistan Medical Association, 2016
To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, a... more To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, and to examine the compatibility of sleep data and clinical features. The study was conducted at the Department of Neurology, Ankara Numune Training and Education Hospital, Ankara, Turkey, and comprised patients who presented to the outpatient clinic between January and July 2014 who were diagnosed with restless leg syndrome based on the International RestIess Leg Syndrome Study Group criteria. Patients underwent polysomnography test in spontaneous sleep in a single room. SPSS 18 was used for statistical analyses. Of the 18 patients, 13(72%)were females and 5(28%)were males. Overall mean age was 51.56±11.57years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10(55.5%) patients had excessive daytime sleepiness; 13(72.2%) reported snoring; and 3(17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40).Mean Epw...
The Journal of Heart and Lung Transplantation, 2018
Purpose
We aimed to analyze flow forms in patients who underwent left ventricular assist device (... more Purpose We aimed to analyze flow forms in patients who underwent left ventricular assist device (LVAD) implantation and to investigate whether these findings affect neurocognitive function. Methods From January 2012 to March 2016, 31 adult patients whom LVAD was implanted were compared with 26 patients with heart failure and 27 healthy volunteers. LVAD group was also classified as “closed”,“1-6 opening” and “7-10 opening” per ten heart beats. Carotid and middle cerebral artery (MCA) flow velocities [peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistance index (RI)] and neurocognitive function test scores were analyzed. Results In the LVAD group, the EDV values of the carotid artery and MCAs were higher than the heart failure group (p< 0.05). PI and RI values of carotid artery and MCAs were found lower in LVAD group, compared to heart failure group (p< 0.001 …
Research
Açıklama
Balo's concentric sclerosis is a rare disease with extreme white matter demyeli... more Research Açıklama Balo's concentric sclerosis is a rare disease with extreme white matter demyelination, myelin loss and preserved myelin tissue. The disease has a monophasic, progressive and fulminant course. We report a case of Balo’s concentric sclerosis responding well to steroid administration.
Background.-Spontaneous intracranial hypotension is a rarely seen benign disease with unknown eti... more Background.-Spontaneous intracranial hypotension is a rarely seen benign disease with unknown etiology. The cardinal symptom is postural headache which occurred without any reason. One or more of the symptoms such as pain or stiffness of the neck, interscapular pain, nausea, vomiting, vertigo, horizontal diplopia, changed in hearing, visual blurring, face numbness and weakness in upper extremities can accompany. Observation.-By the way of the case in which we have diagnosed spontaneous intracranial hypotension with the signs of postural headache, low cerebrospinal fluid pressure and diffuse pachymeningeal contrast enhancement we aimed to bring on date the problems in diagnosis and treatment of this rarely seen antity.
The Medical Bulletin of Sisli Etfal Hospital, 2013
Non-HDL cholesterol, total cholesterol/HDL cholesterol and LDL-cholesterol levels
in patients wit... more Non-HDL cholesterol, total cholesterol/HDL cholesterol and LDL-cholesterol levels in patients with acute ischemic stroke Objective: Ischemic stroke is defined as acute neurological disorder according to cerebral vascular damage and reduced blood flow to a particular region of the brain. Ischemic stroke is a major cause of morbidity and mortality and placed 3rd among the causes of death. About 80% of all strokes depend on ischemic cause. Atherosclerotic plaque rupture or addition of a thrombus on plaque is the most common cause of ischemic stroke. Atherosclerosis is associated with the level of blood lipids from the first stages of the formation process. In our study, we aimed to investigate non-HDL, total cholesterol / HDL-cholesterol and LDL-cholesterol levels in patients with acute ischemic stroke. Methods: This study was performed in 52 patients who were admitted at Ankara Numune Hospital for Education and Investigation, Division of Neurology between December 2009- May 2010 with a diagnosis of acute ischemic stroke in the first 24 hours and 48 healthy individuals matched for age and gender, who was admitted at the hospital during the same period. Total cholesterol, triglycerides and HDL cholesterol levels were measured by DXC 800 autoanalyzer (Beckmann-Coulter, USA). LDL cholesterol, total cholesterol / HDL-cholesterol and non-HDL cholesterol levels were calculated according to the formulas. Results: Patient group had significantly lower HDL-C levels than the control group (p=0.009), whereas the triglyceride and total cholesterol / HDL-C levels were significantly higher (p=0.013, p=0.018). Total cholesterol, LDL cholesterol and non-HDL cholesterol levels did not differ significantly between groups. There were significant correlations between non-HDL-cholesterol levels and triglycerides, total cholesterol, LDL cholesterol (respectively r=0.468, r=0.964, r=0.851) (respectively p<0.001, p<0.001, p<0.001), and there was not a statistically significant correlation between non –HDL -cholesterol and HDL cholesterol. Conclusion: Dyslipidemia process plays a role in the pathogenesis of atherosclerosis which is an important risk factor for acute ischemic stroke. In our study, in terms of total cholesterol, non-HDL cholesterol and LDL cholesterol levels, there was not a significant difference but triglyceride, total cholesterol / HDL-cholesterol and HDL cholesterol levels were found to be significantly different.
Amaç:
Uzun süreli antiepileptik ilaç kullanımının artmış total serum alkalen fosfataz (ALP) düzey... more Amaç: Uzun süreli antiepileptik ilaç kullanımının artmış total serum alkalen fosfataz (ALP) düzeyleri ve azalmış serum kalsiyum (Ca), fosfat (P) ve vitamin D (vit D) düzeyleri ile ilişkili olduğu bilinmektedir. Pek çok epileptik nöbet tipinde kullanılan valproik asit (VA), sitokrom P450 enzimini inhibe eder. Bazı çalışmalarda, valproatın kemik metabolizması üzerinde önemli değişiklik yaptığı, bazılarında yapmadığı belirtilmiştir. Çalışmanın amacı; VA monoterapisi kullanılan epileptik hastalarda, VA'nın kemik metabolizması üzerindeki etkilerini prospektif bir yöntemle araştırmaktır. Gereç ve Yöntemler: Epilepsi polikliniğinde takipli VA kullanan 56 hasta (29 E+ 27 K) alınmıştır ve ilaç kullanım sürelerine göre (0-12 ay, 13-24 ay ve 24 ay ve üzeri olmak üzere) gruplara ayrılmıştır. Kontrol grubuna ilaç kullanım öyküsü olmayan, yaş ve cins uyumlu, 56 sağlıklı birey (29 E+ 27 K) alınmıştır. Hasta ve kontrol grubun, serum Ca, P, total …
Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, inflammation,... more Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, inflammation, axonal/neuronal loss and gliosis of white matter of central nervous system (CNS) with multifactorial etiology including genetic, environmental and immunological factors [1]. Optic neuritis is a common pathology that may affect nearly half of the patients with MS and also may lead to thinning of the retinal nerve fiber layer (RNFL) due to the neuroinflammation of the optic nerve (2). Spain et al (3) reported that RNLF measured by optical coherence tomography (OCT) may be correlated with disease duration and EDSS scores in patients with untreated MS. In another study RNLF was found to discriminate patients with sub types of MS including clinically isolated syndrome patients; relapsing remitting MS patients; secondary progressive MS (4).
Objective: To reveal clinical and polysomnographic features in patients treated for restless leg ... more Objective: To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, and to examine the compatibility of sleep data and clinical features. Methods: The study was conducted at the Department of Neurology, Ankara Numune Training and Education Hospital, Ankara, Turkey, and comprised patients who presented to the outpatient clinic between January and July 2014 who were diagnosed with restless leg syndrome based on the International RestIess Leg Syndrome Study Group criteria. Patients underwent polysomnography test in spontaneous sleep in a single room. SPSS 18 was used for statistical analyses. Results: Of the 18 patients, 13 (72%) were females and 5 (28%) were males. Overall mean age was 51.56±11.57 years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10 (55.5%) patients had excessive daytime sleepiness; 13 (72.2%) reported snoring; and 3 (17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40). Mean Epworth Sleepiness Scale score was 9.17±5.1 (range: 0-20). Conclusion: Restless leg syndrome was more common in women and the most common complaint was insomnia.
By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSA... more By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSAS) and those from patients with simple snoring, we aimed to establish whether OSAS negatively influences cognition. Patients with mild-to-severe OSAS (n = 29) and nonhypoxic simple-snoring patients (n = 30) were admitted to the study. All participants in both groups were evaluated with polysomnography and neurocognitive tests, including the Stroop Test, Rey Auditory Verbal Learning Test, Judgment of Line Orientation, Trail-Making Test, and Symbol Digit Modalities Test (SDMT). Significant differences were identified between the groups for test scores on the Rey 1, SDMT, and Stroop tests. We propose that accurate OSAS diagnosis and treatment might help to prevent cognitive decline.
Objectives
Multiple sclerosis is an inflammatory condition of the central nervous system whose et... more Objectives Multiple sclerosis is an inflammatory condition of the central nervous system whose etiology is influenced by immunologic, genetic, and environmental factors. Aim of the present study was to determine if any relation exists between IL-18 −137C/G and −607C/A gene promoter polymorphisms on the individual susceptibility of multiple sclerosis and also to investigate the possible effect of IL-18 activity regarding this kind of polymorphism and MS.
Patients and methods 113 patients with clinically definite MS and 135 ethnically-matched controls were participated in this study. IL-18 −137C/G and −607C/A gene promoter polymorphisms were analyzed by Sequence Specific Polymerase Chain Reaction (SS-PCR), while levels of serum IL-18 were measured by Enzyme Linked Immunoassay Assay (ELISA) in patients with MS and healthy controls.
Results Our results showed that the IL-18 −607AA genotype indicated 6 times higher risk in the development of MS (OR = 6.883; 3.17–14.96; p < 0.001). According to our findings, smoking seems to be an important confounding factor in MS patients with carrying IL-18 −607 AA and CA + AA genotypes. However, no meaningful association was found with IL-18 −137C/G gene promoter polymorphism.
Conclusion In conclusion, we suggest that IL-18 −607C/A gene promoter polymorphism is a major genetic factor for determining individual susceptibility to MS, where smoking status also increases the risk of MS.
Stroke is a multifactorial disease caused by the combination of certain risk factors and genetic ... more Stroke is a multifactorial disease caused by the combination of certain risk factors and genetic factors. There are possible risk factors having important role in the pathogenesis of stroke. The most important environmental factors are cigarette smoking and oxidative stress which have different sources. GST (M1, T1, P1) have major roles in detoxification of the products of oxidative stress and they are polymorphic. DNA damages can also be repaired by repair enzymes such as OGG1 and XRCC1 which are highly polymorphic and have pivotal roles in repair systems. In the present study, we investigated that polymorphisms in genes involved in detoxification and DNA-repair pathways might modify the individual’s risk for ischemic stroke. Furthermore, the products of oxidative stress and antioxidant capacity were measured and the impact of gene polymorphism on them was evaluated. Our data showed that OGG1 Ser326Cys and XRCC1 Arg399Gln gene polymorphisms had impacts on the development of stroke.
As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of t... more As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of this study was to assess some inflammatory markers in MS patients and their relationships with clinical subgroups and disability status. The serum levels of procalcitonin (PCT), YKL-40, IFN-γ and TNF-α were measured by an ELISA microplate reader in 59 MS patients and in 29 healthy subjects. Mean serum PCT and TNF-α levels were significantly higher in patients with MS than control group (P< 0.001). Serum YKL-40 and IFN-γ concentrations were elevated in MS group compared the healthy subjects, but the difference was not significantly. CIS, RRMS and SPMS groups had higher levels of PCT and TNF-α than control group. YKL-40 levels were positively correlated with EDSS score (r= 0.412, P= 0.001). IFN-γ and TNF-α levels were found to be negatively correlated with EDSS score (r=-0.347, P= 0.007 and r=-0.328, P= 0.011, respectively). Increased levels of these inflammatory markers might provide important contributions to the underlying inflammatory pathways in MS.
Objective: Multiple sclerosis (MS) is an inflammatory demyelinating disease arising from unknown ... more Objective: Multiple sclerosis (MS) is an inflammatory demyelinating disease arising from unknown origin. Dyslipidemia, T-lymphocyte mediated inflammation, lipoprotein associated oxidative activity and lipoprotein associated phospholipase A2 (Lp-PLA2) activity include the pathogenesis of MS. In the current study, we evaluated the effect of Lp-PLA2 activity and serum lipids in MS patients with different clinical stages to understand the effect these parameters on MS progression. Methods: The study included a total of 30 patients and 30 controls. Lp-PLA2 activity, total cholesterol, triglyceride, HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), atherogenic index of plasma (AIP), non HDL cholesterol (non-HDL-C) and total cholesterol to HDL-C ratio (TCHOL/HDL-C) were compared between controls and patients. Additionally, patients were grouped according to their clinical stage and compared each other in terms of serum Lp-PLA2 activity, LDL-C, HDL-C, total cholesterol and triglyceride concentrations. Results: There were no statistically significant differences between patients and controls in terms of Lp-PLA2 activity, total cholesterol, triglyceride, HDL-C, LDL-C, AIP, non-HDL-C and TCHOL/HDL-C. Additionally, no significant difference was observed in terms of Lp-PLA2 activity, total cholesterol, triglyceride, HDL-C and LDL-C concentrations among patients divided according to clinical stage. Conclusion: Serum lipids concentrations and Lp-PLA2 activity are not seem to be involved in MS and its progression. Therefore, we believe that lipids and Lp-PLA2 reducing treatment strategies are not expected to be hopeful in preventing disease occurrence and vasculary events
Pseudotumor cerebri (PTC) is a disease characterized by increased intracranial pressure without i... more Pseudotumor cerebri (PTC) is a disease characterized by increased intracranial pressure without intracranial space occupying lesions or hydrocephaly. PTC is characterized by headache and optic disc edema in classical presentation. Neurological symptoms are rare, out of the sixth nerve palsy. Although focal motor seizures is not typical, neurological symptoms may associate PTC. PTC is usually seen in young-middle aged women and often idiopathic. In this article, a case of pseudotumor cerebri with the focal seizures and its follow up period is presented.
Introduction Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, ... more Introduction Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, inflammation, axonal/neuronal loss and gliosis of white matter of central nervous system (CNS) with multifactorial etiology including genetic, environmental and immunological factors [1]. Optic neuritis is a common pathology that may affect nearly half of the patients with MS and also may lead to thinning of the retinal nerve fiber layer (RNFL) due to the neuroinflammation of the optic nerve (2). Spain et al (3) reported that RNLF measured by optical coherence tomography (OCT) may be correlated with disease duration and EDSS scores in patients with untreated MS. In another study RNLF was found to discriminate patients with sub types of MS including clinically isolated syndrome patients; relapsing remitting MS patients; secondary progressive MS (4).
As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of t... more As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of this study was to assess some inflammatory markers in MS patients and their relationships with clinical subgroups and disability status.
By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSA... more By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSAS) and those from patients with simple snoring, we aimed to establish whether OSAS negatively influences cognition. Patients with mild-to-severe OSAS (n ¼ 29) and nonhypoxic simple-snoring patients (n ¼ 30) were admitted to the study. All participants in both groups were evaluated with polysomnography and neurocognitive tests, including the Stroop Test, Rey Auditory Verbal Learning Test, Judgment of Line Orientation, Trail-Making Test, and Symbol Digit Modalities Test (SDMT). Significant differences were identified between the groups for test scores on the Rey 1, SDMT, and Stroop tests. We propose that accurate OSAS diagnosis and treatment might help to prevent cognitive decline.
JPMA. The Journal of the Pakistan Medical Association, 2016
To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, a... more To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, and to examine the compatibility of sleep data and clinical features. The study was conducted at the Department of Neurology, Ankara Numune Training and Education Hospital, Ankara, Turkey, and comprised patients who presented to the outpatient clinic between January and July 2014 who were diagnosed with restless leg syndrome based on the International RestIess Leg Syndrome Study Group criteria. Patients underwent polysomnography test in spontaneous sleep in a single room. SPSS 18 was used for statistical analyses. Of the 18 patients, 13(72%)were females and 5(28%)were males. Overall mean age was 51.56±11.57years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10(55.5%) patients had excessive daytime sleepiness; 13(72.2%) reported snoring; and 3(17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40).Mean Epw...
The Journal of Heart and Lung Transplantation, 2018
Purpose
We aimed to analyze flow forms in patients who underwent left ventricular assist device (... more Purpose We aimed to analyze flow forms in patients who underwent left ventricular assist device (LVAD) implantation and to investigate whether these findings affect neurocognitive function. Methods From January 2012 to March 2016, 31 adult patients whom LVAD was implanted were compared with 26 patients with heart failure and 27 healthy volunteers. LVAD group was also classified as “closed”,“1-6 opening” and “7-10 opening” per ten heart beats. Carotid and middle cerebral artery (MCA) flow velocities [peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistance index (RI)] and neurocognitive function test scores were analyzed. Results In the LVAD group, the EDV values of the carotid artery and MCAs were higher than the heart failure group (p< 0.05). PI and RI values of carotid artery and MCAs were found lower in LVAD group, compared to heart failure group (p< 0.001 …
Research
Açıklama
Balo's concentric sclerosis is a rare disease with extreme white matter demyeli... more Research Açıklama Balo's concentric sclerosis is a rare disease with extreme white matter demyelination, myelin loss and preserved myelin tissue. The disease has a monophasic, progressive and fulminant course. We report a case of Balo’s concentric sclerosis responding well to steroid administration.
Background.-Spontaneous intracranial hypotension is a rarely seen benign disease with unknown eti... more Background.-Spontaneous intracranial hypotension is a rarely seen benign disease with unknown etiology. The cardinal symptom is postural headache which occurred without any reason. One or more of the symptoms such as pain or stiffness of the neck, interscapular pain, nausea, vomiting, vertigo, horizontal diplopia, changed in hearing, visual blurring, face numbness and weakness in upper extremities can accompany. Observation.-By the way of the case in which we have diagnosed spontaneous intracranial hypotension with the signs of postural headache, low cerebrospinal fluid pressure and diffuse pachymeningeal contrast enhancement we aimed to bring on date the problems in diagnosis and treatment of this rarely seen antity.
The Medical Bulletin of Sisli Etfal Hospital, 2013
Non-HDL cholesterol, total cholesterol/HDL cholesterol and LDL-cholesterol levels
in patients wit... more Non-HDL cholesterol, total cholesterol/HDL cholesterol and LDL-cholesterol levels in patients with acute ischemic stroke Objective: Ischemic stroke is defined as acute neurological disorder according to cerebral vascular damage and reduced blood flow to a particular region of the brain. Ischemic stroke is a major cause of morbidity and mortality and placed 3rd among the causes of death. About 80% of all strokes depend on ischemic cause. Atherosclerotic plaque rupture or addition of a thrombus on plaque is the most common cause of ischemic stroke. Atherosclerosis is associated with the level of blood lipids from the first stages of the formation process. In our study, we aimed to investigate non-HDL, total cholesterol / HDL-cholesterol and LDL-cholesterol levels in patients with acute ischemic stroke. Methods: This study was performed in 52 patients who were admitted at Ankara Numune Hospital for Education and Investigation, Division of Neurology between December 2009- May 2010 with a diagnosis of acute ischemic stroke in the first 24 hours and 48 healthy individuals matched for age and gender, who was admitted at the hospital during the same period. Total cholesterol, triglycerides and HDL cholesterol levels were measured by DXC 800 autoanalyzer (Beckmann-Coulter, USA). LDL cholesterol, total cholesterol / HDL-cholesterol and non-HDL cholesterol levels were calculated according to the formulas. Results: Patient group had significantly lower HDL-C levels than the control group (p=0.009), whereas the triglyceride and total cholesterol / HDL-C levels were significantly higher (p=0.013, p=0.018). Total cholesterol, LDL cholesterol and non-HDL cholesterol levels did not differ significantly between groups. There were significant correlations between non-HDL-cholesterol levels and triglycerides, total cholesterol, LDL cholesterol (respectively r=0.468, r=0.964, r=0.851) (respectively p<0.001, p<0.001, p<0.001), and there was not a statistically significant correlation between non –HDL -cholesterol and HDL cholesterol. Conclusion: Dyslipidemia process plays a role in the pathogenesis of atherosclerosis which is an important risk factor for acute ischemic stroke. In our study, in terms of total cholesterol, non-HDL cholesterol and LDL cholesterol levels, there was not a significant difference but triglyceride, total cholesterol / HDL-cholesterol and HDL cholesterol levels were found to be significantly different.
Amaç:
Uzun süreli antiepileptik ilaç kullanımının artmış total serum alkalen fosfataz (ALP) düzey... more Amaç: Uzun süreli antiepileptik ilaç kullanımının artmış total serum alkalen fosfataz (ALP) düzeyleri ve azalmış serum kalsiyum (Ca), fosfat (P) ve vitamin D (vit D) düzeyleri ile ilişkili olduğu bilinmektedir. Pek çok epileptik nöbet tipinde kullanılan valproik asit (VA), sitokrom P450 enzimini inhibe eder. Bazı çalışmalarda, valproatın kemik metabolizması üzerinde önemli değişiklik yaptığı, bazılarında yapmadığı belirtilmiştir. Çalışmanın amacı; VA monoterapisi kullanılan epileptik hastalarda, VA'nın kemik metabolizması üzerindeki etkilerini prospektif bir yöntemle araştırmaktır. Gereç ve Yöntemler: Epilepsi polikliniğinde takipli VA kullanan 56 hasta (29 E+ 27 K) alınmıştır ve ilaç kullanım sürelerine göre (0-12 ay, 13-24 ay ve 24 ay ve üzeri olmak üzere) gruplara ayrılmıştır. Kontrol grubuna ilaç kullanım öyküsü olmayan, yaş ve cins uyumlu, 56 sağlıklı birey (29 E+ 27 K) alınmıştır. Hasta ve kontrol grubun, serum Ca, P, total …
Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, inflammation,... more Multiple sclerosis (MS) is an autoimmune disorder characterized by demyelinization, inflammation, axonal/neuronal loss and gliosis of white matter of central nervous system (CNS) with multifactorial etiology including genetic, environmental and immunological factors [1]. Optic neuritis is a common pathology that may affect nearly half of the patients with MS and also may lead to thinning of the retinal nerve fiber layer (RNFL) due to the neuroinflammation of the optic nerve (2). Spain et al (3) reported that RNLF measured by optical coherence tomography (OCT) may be correlated with disease duration and EDSS scores in patients with untreated MS. In another study RNLF was found to discriminate patients with sub types of MS including clinically isolated syndrome patients; relapsing remitting MS patients; secondary progressive MS (4).
Objective: To reveal clinical and polysomnographic features in patients treated for restless leg ... more Objective: To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, and to examine the compatibility of sleep data and clinical features. Methods: The study was conducted at the Department of Neurology, Ankara Numune Training and Education Hospital, Ankara, Turkey, and comprised patients who presented to the outpatient clinic between January and July 2014 who were diagnosed with restless leg syndrome based on the International RestIess Leg Syndrome Study Group criteria. Patients underwent polysomnography test in spontaneous sleep in a single room. SPSS 18 was used for statistical analyses. Results: Of the 18 patients, 13 (72%) were females and 5 (28%) were males. Overall mean age was 51.56±11.57 years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10 (55.5%) patients had excessive daytime sleepiness; 13 (72.2%) reported snoring; and 3 (17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40). Mean Epworth Sleepiness Scale score was 9.17±5.1 (range: 0-20). Conclusion: Restless leg syndrome was more common in women and the most common complaint was insomnia.
By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSA... more By comparing neurocognitive test results from patients with obstructive sleep apnea syndrome (OSAS) and those from patients with simple snoring, we aimed to establish whether OSAS negatively influences cognition. Patients with mild-to-severe OSAS (n = 29) and nonhypoxic simple-snoring patients (n = 30) were admitted to the study. All participants in both groups were evaluated with polysomnography and neurocognitive tests, including the Stroop Test, Rey Auditory Verbal Learning Test, Judgment of Line Orientation, Trail-Making Test, and Symbol Digit Modalities Test (SDMT). Significant differences were identified between the groups for test scores on the Rey 1, SDMT, and Stroop tests. We propose that accurate OSAS diagnosis and treatment might help to prevent cognitive decline.
Objectives
Multiple sclerosis is an inflammatory condition of the central nervous system whose et... more Objectives Multiple sclerosis is an inflammatory condition of the central nervous system whose etiology is influenced by immunologic, genetic, and environmental factors. Aim of the present study was to determine if any relation exists between IL-18 −137C/G and −607C/A gene promoter polymorphisms on the individual susceptibility of multiple sclerosis and also to investigate the possible effect of IL-18 activity regarding this kind of polymorphism and MS.
Patients and methods 113 patients with clinically definite MS and 135 ethnically-matched controls were participated in this study. IL-18 −137C/G and −607C/A gene promoter polymorphisms were analyzed by Sequence Specific Polymerase Chain Reaction (SS-PCR), while levels of serum IL-18 were measured by Enzyme Linked Immunoassay Assay (ELISA) in patients with MS and healthy controls.
Results Our results showed that the IL-18 −607AA genotype indicated 6 times higher risk in the development of MS (OR = 6.883; 3.17–14.96; p < 0.001). According to our findings, smoking seems to be an important confounding factor in MS patients with carrying IL-18 −607 AA and CA + AA genotypes. However, no meaningful association was found with IL-18 −137C/G gene promoter polymorphism.
Conclusion In conclusion, we suggest that IL-18 −607C/A gene promoter polymorphism is a major genetic factor for determining individual susceptibility to MS, where smoking status also increases the risk of MS.
Stroke is a multifactorial disease caused by the combination of certain risk factors and genetic ... more Stroke is a multifactorial disease caused by the combination of certain risk factors and genetic factors. There are possible risk factors having important role in the pathogenesis of stroke. The most important environmental factors are cigarette smoking and oxidative stress which have different sources. GST (M1, T1, P1) have major roles in detoxification of the products of oxidative stress and they are polymorphic. DNA damages can also be repaired by repair enzymes such as OGG1 and XRCC1 which are highly polymorphic and have pivotal roles in repair systems. In the present study, we investigated that polymorphisms in genes involved in detoxification and DNA-repair pathways might modify the individual’s risk for ischemic stroke. Furthermore, the products of oxidative stress and antioxidant capacity were measured and the impact of gene polymorphism on them was evaluated. Our data showed that OGG1 Ser326Cys and XRCC1 Arg399Gln gene polymorphisms had impacts on the development of stroke.
As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of t... more As known multiple sclerosis (MS) is a chronic neuroinflammatory progressive disease. The aim of this study was to assess some inflammatory markers in MS patients and their relationships with clinical subgroups and disability status. The serum levels of procalcitonin (PCT), YKL-40, IFN-γ and TNF-α were measured by an ELISA microplate reader in 59 MS patients and in 29 healthy subjects. Mean serum PCT and TNF-α levels were significantly higher in patients with MS than control group (P< 0.001). Serum YKL-40 and IFN-γ concentrations were elevated in MS group compared the healthy subjects, but the difference was not significantly. CIS, RRMS and SPMS groups had higher levels of PCT and TNF-α than control group. YKL-40 levels were positively correlated with EDSS score (r= 0.412, P= 0.001). IFN-γ and TNF-α levels were found to be negatively correlated with EDSS score (r=-0.347, P= 0.007 and r=-0.328, P= 0.011, respectively). Increased levels of these inflammatory markers might provide important contributions to the underlying inflammatory pathways in MS.
Objective: Multiple sclerosis (MS) is an inflammatory demyelinating disease arising from unknown ... more Objective: Multiple sclerosis (MS) is an inflammatory demyelinating disease arising from unknown origin. Dyslipidemia, T-lymphocyte mediated inflammation, lipoprotein associated oxidative activity and lipoprotein associated phospholipase A2 (Lp-PLA2) activity include the pathogenesis of MS. In the current study, we evaluated the effect of Lp-PLA2 activity and serum lipids in MS patients with different clinical stages to understand the effect these parameters on MS progression. Methods: The study included a total of 30 patients and 30 controls. Lp-PLA2 activity, total cholesterol, triglyceride, HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), atherogenic index of plasma (AIP), non HDL cholesterol (non-HDL-C) and total cholesterol to HDL-C ratio (TCHOL/HDL-C) were compared between controls and patients. Additionally, patients were grouped according to their clinical stage and compared each other in terms of serum Lp-PLA2 activity, LDL-C, HDL-C, total cholesterol and triglyceride concentrations. Results: There were no statistically significant differences between patients and controls in terms of Lp-PLA2 activity, total cholesterol, triglyceride, HDL-C, LDL-C, AIP, non-HDL-C and TCHOL/HDL-C. Additionally, no significant difference was observed in terms of Lp-PLA2 activity, total cholesterol, triglyceride, HDL-C and LDL-C concentrations among patients divided according to clinical stage. Conclusion: Serum lipids concentrations and Lp-PLA2 activity are not seem to be involved in MS and its progression. Therefore, we believe that lipids and Lp-PLA2 reducing treatment strategies are not expected to be hopeful in preventing disease occurrence and vasculary events
Pseudotumor cerebri (PTC) is a disease characterized by increased intracranial pressure without i... more Pseudotumor cerebri (PTC) is a disease characterized by increased intracranial pressure without intracranial space occupying lesions or hydrocephaly. PTC is characterized by headache and optic disc edema in classical presentation. Neurological symptoms are rare, out of the sixth nerve palsy. Although focal motor seizures is not typical, neurological symptoms may associate PTC. PTC is usually seen in young-middle aged women and often idiopathic. In this article, a case of pseudotumor cerebri with the focal seizures and its follow up period is presented.
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Papers by Semra Mungan
We aimed to analyze flow forms in patients who underwent left ventricular assist device (LVAD) implantation and to investigate whether these findings affect neurocognitive function.
Methods
From January 2012 to March 2016, 31 adult patients whom LVAD was implanted were compared with 26 patients with heart failure and 27 healthy volunteers. LVAD group was also classified as “closed”,“1-6 opening” and “7-10 opening” per ten heart beats. Carotid and middle cerebral artery (MCA) flow velocities [peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistance index (RI)] and neurocognitive function test scores were analyzed.
Results
In the LVAD group, the EDV values of the carotid artery and MCAs were higher than the heart failure group (p< 0.05). PI and RI values of carotid artery and MCAs were found lower in LVAD group, compared to heart failure group (p< 0.001 …
Açıklama
Balo's concentric sclerosis is a rare disease with extreme white matter demyelination, myelin loss and preserved myelin tissue. The disease has a monophasic, progressive and fulminant course. We report a case of Balo’s concentric sclerosis responding well to steroid administration.
Observation.-By the way of the case in which we have diagnosed spontaneous intracranial hypotension with the signs of postural headache, low cerebrospinal fluid pressure and diffuse pachymeningeal contrast enhancement we aimed to bring on date the problems in diagnosis and treatment of this rarely seen antity.
in patients with acute ischemic stroke
Objective: Ischemic stroke is defined as acute neurological disorder according to cerebral vascular damage
and reduced blood flow to a particular region of the brain. Ischemic stroke is a major cause of morbidity
and mortality and placed 3rd among the causes of death. About 80% of all strokes depend on ischemic
cause. Atherosclerotic plaque rupture or addition of a thrombus on plaque is the most common cause of
ischemic stroke. Atherosclerosis is associated with the level of blood lipids from the first stages of the
formation process. In our study, we aimed to investigate non-HDL, total cholesterol / HDL-cholesterol and
LDL-cholesterol levels in patients with acute ischemic stroke.
Methods: This study was performed in 52 patients who were admitted at Ankara Numune Hospital for
Education and Investigation, Division of Neurology between December 2009- May 2010 with a diagnosis of
acute ischemic stroke in the first 24 hours and 48 healthy individuals matched for age and gender, who was
admitted at the hospital during the same period. Total cholesterol, triglycerides and HDL cholesterol levels
were measured by DXC 800 autoanalyzer (Beckmann-Coulter, USA). LDL cholesterol, total cholesterol /
HDL-cholesterol and non-HDL cholesterol levels were calculated according to the formulas.
Results: Patient group had significantly lower HDL-C levels than the control group (p=0.009), whereas
the triglyceride and total cholesterol / HDL-C levels were significantly higher (p=0.013, p=0.018). Total
cholesterol, LDL cholesterol and non-HDL cholesterol levels did not differ significantly between groups.
There were significant correlations between non-HDL-cholesterol levels and triglycerides, total cholesterol,
LDL cholesterol (respectively r=0.468, r=0.964, r=0.851) (respectively p<0.001, p<0.001, p<0.001), and there
was not a statistically significant correlation between non –HDL -cholesterol and HDL cholesterol.
Conclusion: Dyslipidemia process plays a role in the pathogenesis of atherosclerosis which is an important
risk factor for acute ischemic stroke. In our study, in terms of total cholesterol, non-HDL cholesterol and LDL
cholesterol levels, there was not a significant difference but triglyceride, total cholesterol / HDL-cholesterol and HDL cholesterol levels were found to be significantly different.
Uzun süreli antiepileptik ilaç kullanımının artmış total serum alkalen fosfataz (ALP) düzeyleri ve azalmış serum kalsiyum (Ca), fosfat (P) ve vitamin D (vit D) düzeyleri ile ilişkili olduğu bilinmektedir. Pek çok epileptik nöbet tipinde kullanılan valproik asit (VA), sitokrom P450 enzimini inhibe eder. Bazı çalışmalarda, valproatın kemik metabolizması üzerinde önemli değişiklik yaptığı, bazılarında yapmadığı belirtilmiştir. Çalışmanın amacı; VA monoterapisi kullanılan epileptik hastalarda, VA'nın kemik metabolizması üzerindeki etkilerini prospektif bir yöntemle araştırmaktır.
Gereç ve Yöntemler:
Epilepsi polikliniğinde takipli VA kullanan 56 hasta (29 E+ 27 K) alınmıştır ve ilaç kullanım sürelerine göre (0-12 ay, 13-24 ay ve 24 ay ve üzeri olmak üzere) gruplara ayrılmıştır. Kontrol grubuna ilaç kullanım öyküsü olmayan, yaş ve cins uyumlu, 56 sağlıklı birey (29 E+ 27 K) alınmıştır. Hasta ve kontrol grubun, serum Ca, P, total …
Results: Of the 18 patients, 13 (72%) were females and 5 (28%) were males. Overall mean age was 51.56±11.57 years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10 (55.5%) patients had excessive daytime sleepiness; 13 (72.2%) reported snoring; and 3 (17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40). Mean Epworth Sleepiness Scale score was 9.17±5.1 (range: 0-20).
Conclusion: Restless leg syndrome was more common in women and the most common complaint was insomnia.
Multiple sclerosis is an inflammatory condition of the central nervous system whose etiology is influenced by immunologic, genetic, and environmental factors. Aim of the present study was to determine if any relation exists between IL-18 −137C/G and −607C/A gene promoter polymorphisms on the individual susceptibility of multiple sclerosis and also to investigate the possible effect of IL-18 activity regarding this kind of polymorphism and MS.
Patients and methods
113 patients with clinically definite MS and 135 ethnically-matched controls were participated in this study. IL-18 −137C/G and −607C/A gene promoter polymorphisms were analyzed by Sequence Specific Polymerase Chain Reaction (SS-PCR), while levels of serum IL-18 were measured by Enzyme Linked Immunoassay Assay (ELISA) in patients with MS and healthy controls.
Results
Our results showed that the IL-18 −607AA genotype indicated 6 times higher risk in the development of MS (OR = 6.883; 3.17–14.96; p < 0.001). According to our findings, smoking seems to be an important confounding factor in MS patients with carrying IL-18 −607 AA and CA + AA genotypes. However, no meaningful association was found with IL-18 −137C/G gene promoter polymorphism.
Conclusion
In conclusion, we suggest that IL-18 −607C/A gene promoter polymorphism is a major genetic factor for determining individual susceptibility to MS, where smoking status also increases the risk of MS.
We aimed to analyze flow forms in patients who underwent left ventricular assist device (LVAD) implantation and to investigate whether these findings affect neurocognitive function.
Methods
From January 2012 to March 2016, 31 adult patients whom LVAD was implanted were compared with 26 patients with heart failure and 27 healthy volunteers. LVAD group was also classified as “closed”,“1-6 opening” and “7-10 opening” per ten heart beats. Carotid and middle cerebral artery (MCA) flow velocities [peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI) and resistance index (RI)] and neurocognitive function test scores were analyzed.
Results
In the LVAD group, the EDV values of the carotid artery and MCAs were higher than the heart failure group (p< 0.05). PI and RI values of carotid artery and MCAs were found lower in LVAD group, compared to heart failure group (p< 0.001 …
Açıklama
Balo's concentric sclerosis is a rare disease with extreme white matter demyelination, myelin loss and preserved myelin tissue. The disease has a monophasic, progressive and fulminant course. We report a case of Balo’s concentric sclerosis responding well to steroid administration.
Observation.-By the way of the case in which we have diagnosed spontaneous intracranial hypotension with the signs of postural headache, low cerebrospinal fluid pressure and diffuse pachymeningeal contrast enhancement we aimed to bring on date the problems in diagnosis and treatment of this rarely seen antity.
in patients with acute ischemic stroke
Objective: Ischemic stroke is defined as acute neurological disorder according to cerebral vascular damage
and reduced blood flow to a particular region of the brain. Ischemic stroke is a major cause of morbidity
and mortality and placed 3rd among the causes of death. About 80% of all strokes depend on ischemic
cause. Atherosclerotic plaque rupture or addition of a thrombus on plaque is the most common cause of
ischemic stroke. Atherosclerosis is associated with the level of blood lipids from the first stages of the
formation process. In our study, we aimed to investigate non-HDL, total cholesterol / HDL-cholesterol and
LDL-cholesterol levels in patients with acute ischemic stroke.
Methods: This study was performed in 52 patients who were admitted at Ankara Numune Hospital for
Education and Investigation, Division of Neurology between December 2009- May 2010 with a diagnosis of
acute ischemic stroke in the first 24 hours and 48 healthy individuals matched for age and gender, who was
admitted at the hospital during the same period. Total cholesterol, triglycerides and HDL cholesterol levels
were measured by DXC 800 autoanalyzer (Beckmann-Coulter, USA). LDL cholesterol, total cholesterol /
HDL-cholesterol and non-HDL cholesterol levels were calculated according to the formulas.
Results: Patient group had significantly lower HDL-C levels than the control group (p=0.009), whereas
the triglyceride and total cholesterol / HDL-C levels were significantly higher (p=0.013, p=0.018). Total
cholesterol, LDL cholesterol and non-HDL cholesterol levels did not differ significantly between groups.
There were significant correlations between non-HDL-cholesterol levels and triglycerides, total cholesterol,
LDL cholesterol (respectively r=0.468, r=0.964, r=0.851) (respectively p<0.001, p<0.001, p<0.001), and there
was not a statistically significant correlation between non –HDL -cholesterol and HDL cholesterol.
Conclusion: Dyslipidemia process plays a role in the pathogenesis of atherosclerosis which is an important
risk factor for acute ischemic stroke. In our study, in terms of total cholesterol, non-HDL cholesterol and LDL
cholesterol levels, there was not a significant difference but triglyceride, total cholesterol / HDL-cholesterol and HDL cholesterol levels were found to be significantly different.
Uzun süreli antiepileptik ilaç kullanımının artmış total serum alkalen fosfataz (ALP) düzeyleri ve azalmış serum kalsiyum (Ca), fosfat (P) ve vitamin D (vit D) düzeyleri ile ilişkili olduğu bilinmektedir. Pek çok epileptik nöbet tipinde kullanılan valproik asit (VA), sitokrom P450 enzimini inhibe eder. Bazı çalışmalarda, valproatın kemik metabolizması üzerinde önemli değişiklik yaptığı, bazılarında yapmadığı belirtilmiştir. Çalışmanın amacı; VA monoterapisi kullanılan epileptik hastalarda, VA'nın kemik metabolizması üzerindeki etkilerini prospektif bir yöntemle araştırmaktır.
Gereç ve Yöntemler:
Epilepsi polikliniğinde takipli VA kullanan 56 hasta (29 E+ 27 K) alınmıştır ve ilaç kullanım sürelerine göre (0-12 ay, 13-24 ay ve 24 ay ve üzeri olmak üzere) gruplara ayrılmıştır. Kontrol grubuna ilaç kullanım öyküsü olmayan, yaş ve cins uyumlu, 56 sağlıklı birey (29 E+ 27 K) alınmıştır. Hasta ve kontrol grubun, serum Ca, P, total …
Results: Of the 18 patients, 13 (72%) were females and 5 (28%) were males. Overall mean age was 51.56±11.57 years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10 (55.5%) patients had excessive daytime sleepiness; 13 (72.2%) reported snoring; and 3 (17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40). Mean Epworth Sleepiness Scale score was 9.17±5.1 (range: 0-20).
Conclusion: Restless leg syndrome was more common in women and the most common complaint was insomnia.
Multiple sclerosis is an inflammatory condition of the central nervous system whose etiology is influenced by immunologic, genetic, and environmental factors. Aim of the present study was to determine if any relation exists between IL-18 −137C/G and −607C/A gene promoter polymorphisms on the individual susceptibility of multiple sclerosis and also to investigate the possible effect of IL-18 activity regarding this kind of polymorphism and MS.
Patients and methods
113 patients with clinically definite MS and 135 ethnically-matched controls were participated in this study. IL-18 −137C/G and −607C/A gene promoter polymorphisms were analyzed by Sequence Specific Polymerase Chain Reaction (SS-PCR), while levels of serum IL-18 were measured by Enzyme Linked Immunoassay Assay (ELISA) in patients with MS and healthy controls.
Results
Our results showed that the IL-18 −607AA genotype indicated 6 times higher risk in the development of MS (OR = 6.883; 3.17–14.96; p < 0.001). According to our findings, smoking seems to be an important confounding factor in MS patients with carrying IL-18 −607 AA and CA + AA genotypes. However, no meaningful association was found with IL-18 −137C/G gene promoter polymorphism.
Conclusion
In conclusion, we suggest that IL-18 −607C/A gene promoter polymorphism is a major genetic factor for determining individual susceptibility to MS, where smoking status also increases the risk of MS.