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1.
Clin Neurol Neurosurg ; 202: 106500, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33508648

ABSTRACT

OBJECTIVE: Multiple sclerosis (MS) is a demyelinating chronic inflammatory disease of the central nervous system (CNS). Recent studies have shown that oxidative stress plays an important role in MS pathogenesis. This study aimed to investigate the relationship between total oxidative stress (TOS) and total antioxidant capacity (TAC), which were reported to be effective in the pathogenesis of MS, and therapeutic efficacy of fingolimod used in the treatment of MS. MATERIALS AND METHODS: Serum TOS and total TAC levels of 25 patients with relapsing-remitting MS (RRMS) were measured before fingolimod treatment was initiated and in the third month of treatment and compared with those of 40 healthy individuals. Measurement of TOS activity was performed with TOS Assay Kit (Rel Assay Diagnostics, Turkey). Measurement of TAC activity was also performed with TAC Assay Kit (Rel Assay Diagnostics, Turkey). RESULTS: A statistically significant increase was observed in the TOS levels measured before fingolimod treatment in the patient group compared to the control group. The TOS levels measured in the third month of the treatment were found to decrease significantly compared to the pre-treatment TOS levels. An increase was observed in TAC levels after the treatment; however, no significant difference was found between the groups in terms of TAC levels. There was a positive correlation between the pre- and post-treatment Expanded Disability Status Scale (EDSS) scores and TOS values whereas no significant correlation was observed between the pre- and post-treatment EDSS scores and TAC values. CONCLUSION: The present study has revealed that fingolimod reduced oxidative stress. There was a positive correlation between the pre- and post-treatment EDSS and TOS values, which confirmed that there was a close correlation between the MS and oxidative stress. There are some limitations in this study. The small number of patients and the short follow-up times can be listed among these limitations. Our study does not contain a definitive answer to what is the mechanism of increased TOS in MS patients and how fingolimod reduces TOS levels. More detailed studies are needed on this subject.


Subject(s)
Antioxidants/metabolism , Fingolimod Hydrochloride/therapeutic use , Multiple Sclerosis, Relapsing-Remitting/drug therapy , Oxidants/metabolism , Oxidative Stress , Sphingosine 1 Phosphate Receptor Modulators/therapeutic use , Adjuvants, Immunologic/therapeutic use , Adult , Case-Control Studies , Female , Glatiramer Acetate/therapeutic use , Humans , Interferon beta-1a/therapeutic use , Interferon beta-1b/therapeutic use , Male , Multiple Sclerosis, Relapsing-Remitting/metabolism , Multiple Sclerosis, Relapsing-Remitting/physiopathology , Treatment Outcome
2.
Arch Med Sci ; 11(5): 958-63, 2015 Oct 12.
Article in English | MEDLINE | ID: mdl-26528336

ABSTRACT

INTRODUCTION: Discrimination of stroke and stroke mimics is problematic in young patients. The aim of the study was to determine whether arterial ischemic stroke and stroke mimics can be differentiated via the red cell distribution width (RDW) value in young patients. MATERIAL AND METHODS: In this retrospective cross-sectional study, a total of 236 patients hospitalized at the neurology ward were investigated. The patients were divided into 3 groups: the 1(st) group included young stroke patients, the 2(nd) group included patients with epilepsy, and the 3rd group included patients with multiple sclerosis (MS). Complete blood count and computed tomographic brain imaging tests were performed in all patients, and magnetic resonance imaging was done when necessary. RESULTS: A total of 236 patients were included in this study. Ninety-five (40%) patients were young stroke patients, 71 (30%) had epilepsy and 70 (30%) had MS. The mean RDW values of young patients with stroke were significantly higher than patients with epilepsy or MS (14.9 ±1.2, 13.3 ±1.2, 13.4 ±0.6, p < 0.0001, respectively). The diagnostic power of RDW in the differentiation of patients with stroke is good (area under the curve (AUC) = 0.89). When an RDW cut-off value of 14.05% is accepted for differentiating young patients with stroke from other disorders, the sensitivity, specificity, positive predictive and negative predictive values were 73.7%, 87.9%, 6.1 and 0.043, respectively. CONCLUSIONS: Red cell distribution width is a promising, rapid, easy and inexpensive parameter to distinguish young stroke from stroke mimics (such as epilepsy and MS) in young patients.

3.
Arch Physiol Biochem ; 121(3): 97-102, 2015.
Article in English | MEDLINE | ID: mdl-26120045

ABSTRACT

Anti-epileptic drugs (AEDs) have been widely used in patients with epilepsy. This study evaluated the adverse effects of two commonly prescribed AED monotherapies, carbamazepine (CBZ) and valproic acid (VPA). The aim of this study was to evaluate the influence of these anti-epileptic drugs on paraoxonase-1 (PON-1), glutathione S-transferase (GST) and acetyl cholinesterase (AChE) activities in the serum of adult patients with epilepsy. Of the 56 epileptic adults, 28 were given valproate, and the remaining 28 were given carbamazepine. Glutathione (GSH) levels in epilepsy patients receiving anti-epileptic drug treatment were insignificantly higher compared with controls. GST activity in epilepsy patients receiving anti-epileptic drug treatment was insignificantly lower compared with controls. PON1 and AChE activity in epilepsy patients receiving anti-epileptic drug treatment was significantly lower compared with controls. PON1 and AChE activities in the serum of patients treated with carbamazepine monotherapy were lower than in patients treated with valproic acid monotherapy.


Subject(s)
Anticonvulsants/therapeutic use , Antioxidants/metabolism , Carbamazepine/therapeutic use , Epilepsy/blood , Epilepsy/drug therapy , Valproic Acid/therapeutic use , Acetylcholinesterase/blood , Adult , Aryldialkylphosphatase/blood , Case-Control Studies , Epilepsy/physiopathology , Female , GPI-Linked Proteins/blood , Glutathione/blood , Glutathione Transferase/blood , Humans , Male , Middle Aged
4.
Int J Neurosci ; 125(6): 464-73, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25069044

ABSTRACT

AIM: The aim of this study was to investigate the effects of telmisartan on nerve healing in a rat peripheral nerve injury model. MATERIAL AND METHOD: Thirty adult male Wistar albino rats were divided into five groups: healthy, axonotmesis, anastomosis, axonotmesis+10 mg/kg telmisartan and anastomosis+10 mg/kg telmisartan. Walking track analyses were performed 4 weeks after the surgery. The right sciatic nerves of all the animals were examined histopathologically, stereologically and molecularly. RESULTS: Many badly damaged axons were detected in the axonotmesis group, in addition to enlarged spaces between the axons. In the anastomosis group, both ir- regular and degenerated axons at different severities were observed. The sections of the telmisartan group after the axonotmesis were similar to those of the healthy group. The sections of the telmisartan group after the anastomosis were similar to those of the healthy group and the telmisartan group after the axonotmesis. Interleukin-1 beta (IL-1ß) gene expression increased in both the axonotmesis and the anastomosis groups when compared with the healthy group. Telmisartan had a significant down-regulatory effect on IL-1ß expression. Caspase-3 mRNA expression was significantly increased in the anastomosis group, and the administration of telmisartan in this group significantly decreased this rise in caspase-3 mRNA expression. As a functional outcome, telmisartan also increased the walking distance of the rats after axonotmesis and anastomosis. CONCLUSION: The histopathological, stereological, functional and molecular data suggest that telmisartan improves nerve regeneration in peripheral nerve injuries by inhibiting inflammatory cytokine IL-1ß and apoptotic caspase-3.


Subject(s)
Angiotensin II Type 1 Receptor Blockers/therapeutic use , Benzimidazoles/therapeutic use , Benzoates/therapeutic use , Disease Models, Animal , Sciatic Neuropathy/drug therapy , Sciatic Neuropathy/etiology , Analysis of Variance , Animals , Caspase 3/genetics , Caspase 3/metabolism , Gene Expression Regulation/drug effects , Interleukin-1beta/genetics , Interleukin-1beta/metabolism , Locomotion/drug effects , Male , RNA, Messenger/metabolism , Rats , Rats, Wistar , Sciatic Neuropathy/pathology , Telmisartan , Time Factors
5.
Microsurgery ; 35(3): 183-9, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25196975

ABSTRACT

INTRODUCTION: The sensory reconstruction of the lower extremity is one of the main goals in lower extremity reconstruction. Reconstructive options endowing sensory recovery are limited. The aim of this report is to evaluate the neurotized sural flap in reconstruction of foot and ankle defects. PATIENTS AND METHODS: Seven cases that were operated for foot and ankle skin defects with the neurotized sural flap were reported. The largest flap was 10 cm × 14 cm in size. Median age was 38 years. Four defects were on the heel, two were on the ankle, and one was on the dorsum of the foot. The sural nerve was coaptated to a recipient nerve in seven patients. RESULTS: All flaps survived totally. Follow-up time ranged between 9 and 29 months. All cases had hot-cold perception and two-point discrimination at average 14 ± 1.63 mm at 6th month. Sensory conduction test revealed very low action potentials related to stimulation of the flap. CONCLUSION: The neurotized sural flap is a versatile modification, for the sensory reconstruction of the moderate size foot and ankle defects.


Subject(s)
Foot Injuries/surgery , Free Tissue Flaps/innervation , Plastic Surgery Procedures/methods , Soft Tissue Injuries/surgery , Sural Nerve/transplantation , Adolescent , Adult , Aged , Child , Female , Follow-Up Studies , Free Tissue Flaps/transplantation , Humans , Male , Middle Aged , Treatment Outcome , Young Adult
6.
Basic Clin Pharmacol Toxicol ; 116(3): 236-43, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25200216

ABSTRACT

Diabetes mellitus (DM) is a major problem all over the world, affecting more people in recent years. Individuals with diabetes are more prone to disease than non-diabetics, especially vascular complications. The aim of this study was to examine the roles of the endothelin (ET)-1 in brain damage formed in a streptozocin (STZ)-induced diabetes model, and the effect of bosentan, which is the non-specific ET1 receptor blocker in the prevention of the diabetes-induced brain damage. To examine the effects of bosentan (50 mg/kg and 100 mg/kg) in this study, the rats were given the drug for 3 months. The rats were divided into four groups: the sham group (n = 10), the diabetic control group (n = 10), the group of diabetic rats given bosentan 50 mg/kg (n = 10) and the group of diabetic rats given bosentan 100 mg/kg (n = 10). Diabetes was induced in the rats by STZ (60 mg/kg i.p.). On day 91, all rats were killed. Brain tissues of the rats were measured by molecular, biochemical and histopathological methods. Antioxidant levels in the therapy groups were observed as quite near to the values in the healthy group. In this study, while the brain eNOS levels in the diabetic groups decreased, the ET1 and iNOS levels were found to be increased. However, in the diabetes group, hippocampus and cerebellum, pericellular oedema and a number of neuronal cytoretraction were increased in neuropiles, whereas these results were decreased in the therapy group. Based on all of these results, ET1 will not be ignored in diabetes-induced cerebral complications.


Subject(s)
Diabetes Mellitus, Experimental/physiopathology , Endothelin Receptor Antagonists/pharmacology , Endothelin-1/metabolism , Sulfonamides/pharmacology , Animals , Antioxidants/metabolism , Bosentan , Brain/drug effects , Brain/pathology , Dose-Response Relationship, Drug , Endothelin Receptor Antagonists/administration & dosage , Male , Nitric Oxide Synthase Type II/metabolism , Nitric Oxide Synthase Type III/metabolism , Rats , Rats, Wistar , Streptozocin , Sulfonamides/administration & dosage
7.
Clin Appl Thromb Hemost ; 21(4): 354-8, 2015 May.
Article in English | MEDLINE | ID: mdl-24085745

ABSTRACT

BACKGROUND: Diagnosing cerebral venous sinus thrombosis (CVST) in patients referring to emergency service or neurology outpatient unit with complaints of headache is a challenging task. Magnetic resonance (MR) venography is the gold standard, but there are limitations regarding its use. AIM: To evaluate the validity of red cell distribution width (RDW) in CVST diagnosis in patients presenting with headache. METHODS: A total of 138 patients comprising 37 patients with CVST and 101 control primer headache cases were included in this retrospective cross-sectional study. Control group consists of hospitalized patients with primary headache. Venous blood hemoglobin (Hb), platelet, mean corpuscular volume (MCV), RDW, fibrinogen, and vitamin B12 levels of the patients were recorded at the first referral. Diagnosis of CVST was established by MR venography. RESULTS: The RDW ratio of patients with a diagnosis of CVST was significantly higher than that in patients with primary headache (15.3 ± 1.4 vs 13.3 ± 0.5; P <.0001). Fibrinogen and vitamin B12 levels were not significantly different between the 2 groups. In a total of 11 patients, there was more than 1 thrombosis. In 21 of the patients with CVST, gene mutation was detected. There was no significant difference between the patients with and without mutations regarding RDW values. Diagnostic validity of RDW was found to be excellent in differentiating patients with CVST and primary headache (area under the curve = 0.996; 95% CI: 0.990-1.000). Optimum RDW cutoff value was determined as 14.1% (sensitivity: 91.9%, specificity: 99%, positive predictive value: 92.8, negative predictive value: 0.082). CONCLUSION: We suppose that among patients presenting with the complaint of headache, RDW value may lead to diagnose CVST.


Subject(s)
Erythrocyte Indices , Headache/blood , Headache/diagnosis , Intracranial Thrombosis/blood , Intracranial Thrombosis/diagnosis , Adult , Cross-Sectional Studies , Headache/genetics , Humans , Intracranial Thrombosis/genetics , Middle Aged , Retrospective Studies
8.
Int J Neurosci ; 124(12): 935-43, 2014 Dec.
Article in English | MEDLINE | ID: mdl-24617291

ABSTRACT

AIM: The present study aimed to demonstrate protective effects of alpha lipoic acid on experimental sciatic nerve crush injury model assessed with functional and electronmicroscopy analyses. METHODS: In this study, groups were; Group 1; sham operated, Group 2; applied only sciatic nerve crush (Control), Group 3; Sciatic nerve crush + treated ALA 25 mg/kg (received orally) and Group 4; Sciatic nerve crush + treated ALA 50 mg/kg. Subsequently, sciatic nerves crush injury induced by forceps. At the second and fourth week, all animals were evaluated for sciatic functional index (SFI) and histomorphometric analyses with electronmicroscopy. RESULTS: The SFI was significantly increased for both ALA-treated groups 30 days post-injury compared with control groups. The elecronmicroscopy results demonstrated that the axon diameter, the myelin diameter, the area of regenerating axon and miyelin were better in the treatment group than in the control group. Also ALA decreased IL-1ß and Caspase 3 levels that increased in SNC group. CONCLUSIONS: These results suggest that ALA neuroprotective agent for peripheral nerve injury (PNI) and promoted peripheral nerve regeneration via its anti-inflammatory and antiapoptotic effects.


Subject(s)
Nerve Crush , Neuroprotective Agents/pharmacology , Sciatic Nerve/drug effects , Sciatic Nerve/injuries , Thioctic Acid/pharmacology , Animals , Female , Microscopy, Electron/methods , Rats , Rats, Wistar , Sciatic Nerve/metabolism
9.
ScientificWorldJournal ; 2014: 624395, 2014.
Article in English | MEDLINE | ID: mdl-24558318

ABSTRACT

We investigated the relationship of serum nitric oxide (NO) and asymmetrical dimethylarginine (ADMA) levels with cognitive functioning in patients with major depressive disorder (MDD). 41 MDD patients (Beck depression scale scores>16) and 44 controls were included in the study. Rey verbal learning and memory test, auditory consonant trigram test, digit span test, Wisconsin card sorting test, continuous performance task (TOVA), and Stroop test scores were found to be impaired in patients with major depressive disorder when compared to healthy controls. There was no significant difference between patient and control groups in terms of serum NO and ADMA. Serum NO levels were correlated with TOVA test error scores and Stroop test time scores, whereas serum ADMA levels were negatively correlated with TOVA test error scores. Metabolic detriments especially in relation to NO metabolism in frontal cortex and hypothalamus, psychomotor retardation, or loss of motivation may explain these deficits.


Subject(s)
Arginine/analogs & derivatives , Attention/physiology , Depressive Disorder, Major/blood , Depressive Disorder, Major/diagnosis , Nitric Oxide/blood , Psychiatric Status Rating Scales , Adult , Arginine/blood , Biomarkers/blood , Depressive Disorder, Major/psychology , Female , Humans , Male , Neuropsychological Tests , Young Adult
10.
Turk J Med Sci ; 44(4): 624-9, 2014.
Article in English | MEDLINE | ID: mdl-25551933

ABSTRACT

BACKGROUND/AIM: To determine the frequency of migraine in the eastern part of Turkey and its sociodemographic characteristics, impact on disability, and clinical aspects. MATERIALS AND METHODS: The study was conducted door-to-door in the eastern part of Turkey. Those who suffered from headaches were diagnosed with migraine as per the 2004 diagnosis criteria of the International Headache Society and its frequency was determined. Demographic data and Migraine Disability Assessment Scale (MIDAS) scores were recorded. RESULTS: Of the individuals evaluated, 60.4% (883) suffered from headaches, of which 43.6% (637) were evaluated as nonmigraine and 16.8% (246) as migraine headaches. Migraine prevalence was detected to be 10.3% (75) in men and 23.1% (171) in women. When the MIDAS scale was considered, 7.3% of the patients were classified with mild pain, 36.9% with mild to moderate pain, 41% with moderate pain, and 14.6% with severe pain. CONCLUSION: Migraine headache has a wide and complex range of symptoms and is frequently observed in women and young adults. The prevalence of migraine among the general population of eastern Turkey was found to be similar to the averages in the rest of the country, as well to the averages of studies in Europe.


Subject(s)
Migraine Disorders/epidemiology , Absenteeism , Adolescent , Adult , Age Factors , Cost of Illness , Disability Evaluation , Female , Humans , Male , Middle Aged , Migraine Disorders/diagnosis , Pain Measurement , Prevalence , Sex Factors , Socioeconomic Factors , Turkey/epidemiology , Young Adult
11.
Eurasian J Med ; 46(2): 78-83, 2014 Jun.
Article in English | MEDLINE | ID: mdl-25610303

ABSTRACT

OBJECTIVE: Although tension-type headache (TTHA) is one of the most frequently encountered diseases in the general population, relatively few studies have been conducted on this health condition. The published data are limited on the frequency of TTHA in Turkey, and no studies to date have been initiated on the prevalence of TTHA in the city of Erzurum or the Eastern Anatolian Region. MATERIALS AND METHODS: The study was conducted using in-depth interviews from 1972 individuals from city of Erzurum. TTHA was queried in patients with a history of headache, according to the International Classification of Headache Disorders diagnostic criteria, and the frequency of TTHA was investigated. RESULTS: A total of 1972 patients were enrolled in this study. The frequency reached a peak between the ages of 40-49 years (35%), and it significantly declined after the age of 49. During an examination (palpation), cranial muscle sensitivity was detected in 33% of the patients. CONCLUSION: The frequency of TTHA has been identified as 22.3% in patients between the ages of 18-65. The frequency of tension type headache in the city of Erzurum was lower than that in the general population of Turkey.

12.
Anal Quant Cytopathol Histpathol ; 35(4): 217-25, 2013 Aug.
Article in English | MEDLINE | ID: mdl-24341125

ABSTRACT

OBJECTIVE: To examine whether or not there is a possible relationship between the neuron density of trigeminal ganglion (TGG) and the severity of posterior communicating artery (PComA) vasodilation values after permanent bilateral common carotid artery ligation (BCCAL). STUDY DESIGN: This study included 25 rabbits. Both the common carotid arteries of 20 rabbits were explored and denervated. Five animals served as controls. Permanent BCCAL was applied in 15 of the 20 rabbits, and the other 5 were used as the SHAM group without ligation. All animals were followed for 2 months and then sacrificed. Their brains and cranial nerves were extracted and fixed in 10% formalin solution. The relationship between PComA vasodilation values and TGG neuron densities were compared. RESULTS: Elongation, convolution and enlargement were detected in all the basilar arteries of all ligated animals and 2 from the SHAM group. On histopathogical examination vascular wall thinning, luminal enlargement, flattened inner elastic membrane, flattened vessel muscle cells, endothelial desquamation and intimal erosions were detected. An inverse relationship was discovered between the neuron density of TGG and the severity of PComA vasodilation index. CONCLUSION: BCCAL may lead to important beneficial and hazardous histomorphological changes at the posterior communicating artery. The high neuron density of TGG may provide a beneficial effect by facilitating PComA enlargement via its vasodilatory properties for the increase of decreased cerebral circulation, although this situation may be hazardous for certain subjects with congenital or acquired cerebrovascular pathologies.


Subject(s)
Carotid Artery, Common/innervation , Carotid Artery, Common/pathology , Cerebrovascular Circulation/physiology , Posterior Cerebral Artery/innervation , Posterior Cerebral Artery/pathology , Trigeminal Ganglion/physiology , Animals , Basilar Artery/innervation , Basilar Artery/pathology , Basilar Artery/physiopathology , Carotid Artery, Common/physiopathology , Denervation , Disease Models, Animal , Ligation , Posterior Cerebral Artery/physiopathology , Rabbits , Trigeminal Ganglion/cytology , Vasodilation/physiology
13.
Adv Ther ; 30(9): 845-53, 2013 Sep.
Article in English | MEDLINE | ID: mdl-24105435

ABSTRACT

INTRODUCTION: Carotid artery stenting (CAS) is believed to be an alternative to carotid endarterectomy (CEA); however, recent studies have demonstrated an increase of complications with stenting that does not reflect our experience. We thus wanted to compare the periprocedural and 1-year follow-up outcomes of CAS with those of CEA among patients with symptomatic extracranial carotid stenosis in a population from eastern Turkey. METHODS: The hospital records of all patients who underwent carotid artery revascularization were retrospectively reviewed. Patients were divided into two groups based on the type of carotid revascularization performed, namely CEA or CAS. Comparisons were made with respect to 30-day and 1-year outcomes of transient ischemic attack (TIA), myocardial infarction (MI), stroke, and all-cause death rates. Composite endpoints for both groups were also analyzed. RESULTS: Thirty-two CEA and 33 CAS procedures were performed for symptomatic occlusive carotid disease. Baseline characteristics were similar between both groups except for the incidence of diabetes mellitus. No significant differences were found with respect to 30-day mortality, MI, and neurologic morbidity endpoints for CEA and CAS procedures. In the postprocedural 1-year follow-up, only TIA was observed to be significantly higher in the CAS group; the other endpoints did not differ significantly. One-year composite endpoints did not differ between both groups (log-rank P = 0.300). CONCLUSION: In our trial of patients with symptomatic carotid artery stenosis, no significant difference could be shown in periprocedural outcomes, postprocedural outcomes except TIA, and in composite endpoints between the CEA and CAS groups. CAS is a safe and efficacious alternative for the treatment of symptomatic carotid artery stenosis.


Subject(s)
Amaurosis Fugax/surgery , Carotid Artery, Internal/surgery , Carotid Stenosis/surgery , Endarterectomy, Carotid/methods , Ischemic Attack, Transient/surgery , Stents , Stroke/surgery , Aged , Aged, 80 and over , Amaurosis Fugax/etiology , Angiography , Carotid Stenosis/complications , Cohort Studies , Endovascular Procedures/methods , Female , Humans , Ischemic Attack, Transient/etiology , Ischemic Attack, Transient/prevention & control , Male , Middle Aged , Retrospective Studies , Secondary Prevention , Stroke/etiology , Stroke/prevention & control , Treatment Outcome
14.
Acta Neurol Belg ; 113(2): 127-31, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23111777

ABSTRACT

Essential tremor (ET) is one of the common neurological diseases and it is the most common movement disorder in adults. The main clinical finding in patients with ET is kinetic tremor in the arms. There is no adequate study investigating the prevalence of ET in Turkey. Therefore, this study was planned in the center of the city of Erzurum in order to determine the prevalence of essential tremor in our region. This study was performed door to door in the center of the city of Erzurum. ET screening questionnaires were administered to all participants between the ages of 18-60 at first stage. Those who answer yes to any of the first five questions of the questionnaire were evaluated. Patients without a clear differential diagnosis were called for examination to the neurology department and they were re-evaluated by a faculty member specializing in movement disorders. Patients were classified by using Washington Heights-Inwood Genetic Study of Essential Tremor diagnostic and clinical evaluation scale. The prevalence of ET was calculated as 1.60 % (64 out of 4,024 participants). 30 of the cases were male and 34 were female. First-degree relatives of 30 patients with ET had a history of tremor. While 52 patients had tremor only in their hands, 11 patients had in various organs including hands. There was isolated head tremor in one patient. ET prevalence was increasing with age. The prevalence of ET in people between the ages of 18 and 60 was calculated as 1.60 %. This value is compatible with other measurements of the prevalence of ET.


Subject(s)
Essential Tremor/epidemiology , Heart Diseases/epidemiology , Hyperlipidemias/epidemiology , Hypertension/epidemiology , Kidney Diseases/epidemiology , Adolescent , Adult , Age Distribution , Chronic Disease , Female , Humans , Logistic Models , Male , Middle Aged , Prevalence , Risk Factors , Surveys and Questionnaires , Turkey/epidemiology , Young Adult
15.
World Neurosurg ; 80(3-4): 390-5, 2013.
Article in English | MEDLINE | ID: mdl-23247027

ABSTRACT

BACKGROUND: Acute hydrocephalus (ventricular enlargement within 72 hours) is a common complication in patients with aneurysmal subarachnoid hemorrhage (SAH). Cerebrospinal fluid (CSF) secretion may be increased in the early phases of SAH, but it has not been proved definitively. We studied the histologic features of choroid plexus (CP) in the early and late phases of SAH. METHODS: This study was conducted on 20 rabbits, with 5 rabbits in the control group, 5 rabbits in the sham group, and 10 rabbits in the SAH group. In the SAH group, five of the animals were decapitated after 2 days of cisternal blood injections, and the other five animals were decapitated after 14 days of injections. The CP of lateral ventricles were obtained from coronary sections of brains at the level of the temporal horns of the lateral ventricles. Sections were stained with hematoxylin and eosin and Masson trichrome for SAH-related damage and examined stereologically to discern water-filled vesicles, which were counted. Sections were compared statistically. RESULTS: The mean numbers of water vesicles were different after SAH between the early decapitated group (group III) and the late decapitated group (group IV). The mean numbers of water vesicles were 2.80 (± 0.05) in the control group (group I), 2.76 (± 0.02) in the sham group (group II), 14.68 (± 0.06) in the early decapitated group (group III), and 4.78 (± 0.13) in the late decapitated group (group IV). Total number of fluid-filled vesicles of CP was also assessed stereologically; the total numbers were 840 (± 16) in group I, 828 (± 7) in group II, 4404 (± 19) in group III, and 1434 (± 41) in group IV. The numbers of water-filled cisterns were significantly increased in the early phases of SAH (P < 0.05). CONCLUSIONS: In SAH with aneurysm rupture, increased CSF secretion seems to be triggered by hemorrhage in the early phase, but it is not possible in the late phase because of CP degeneration. In the early phase of hemorrhage, CSF secretion may be stimulated by the irritant receptor glossopharyngeal and vagal nerve endings, which innervate the healthy CP epithelium and arteries. Our findings may be accepted as being causative. It is likewise possible that CSF blockage per se leads to hydrocephalus, and the morphologic changes are sequelae that occur later in the course of disease. This is the first study to show the water vesicles of CP as a causative factor in the development of acute hydrocephalus after SAH.


Subject(s)
Hydrocephalus/etiology , Hydrocephalus/pathology , Subarachnoid Hemorrhage/complications , Algorithms , Animals , Brain/pathology , Cerebrovascular Circulation/physiology , Choroid Plexus/pathology , Cisterna Magna/blood supply , Fourth Ventricle/pathology , Fourth Ventricle/surgery , Hydrocephalus/surgery , Rabbits , Subarachnoid Hemorrhage/pathology , Subarachnoid Hemorrhage/surgery
16.
Arch Med Sci ; 9(6): 1125-31, 2013 Dec 30.
Article in English | MEDLINE | ID: mdl-24482661

ABSTRACT

INTRODUCTION: Phrenic nerves have important roles on the management of respiration rhythm. Diaphragm paralysis is possible in phrenic nerve roots ischemia in subarachnoid hemorrhage (SAH). We examined whether there is a relationship between phrenic nerve root ischemia and respiratory disturbances in SAH. MATERIAL AND METHODS: This study was conducted on 5 healthy control and 14 rabbits with experimentally induced SAH by injecting autologous blood into their cisterna magna. Animals were followed up via monitors for detecting the heart and respiration rhythms for 20 days and then decapitaed by humanely. Normal and degenerated neuron densities of phrenic nerve root at the level of C4 dorsal root ganglia (C4DRG) were estimated by Stereological methods. Between the mean numerical density of degenerated neurons of C4DRG and respiratory rate/minute of groups were compared statistically. RESULTS: Phrenic nerve roots, artery and diaphragm muscles degeneration was detected in respiratory arrest developed animals. The mean neuronal density of C4DRG was 13272 ±1201/mm3 with a mean respiration rate of 23 ±4/min in the control group. The mean degenerated neuron density was 2.240 ±450/mm(3) and respiration rhythm was 31 ±6/min in survivors. But, the mean degenerated neuron density was 5850 ±650/mm(3) and mean respiration rhythm was 34 ±7/min in respiratory arrest developed animals (n = 7). A linear relationship was noticed between the degenerated neuron density of C4DRG and respiraton rate (r = -0.758; p < 0.001). CONCLUSIONS: Phrenic nerve root ischemia may be an important factor in respiration rhythms deteriorations in SAH which has not been mentioned in the literature.

17.
Acta Neurol Belg ; 112(4): 351-6, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22581515

ABSTRACT

Matrix metalloproteinases (MMP) constitute an endopeptidase family involved in various physiological and pathological processes. It was demonstrated that plasma MMP-9 level was increased in patients with acute ischemic stroke. In this study, it was investigated whether there was a relationship between the levels of plasma MMP-9 and the severity of stroke and infarct volume in patients with acute ischemic stroke. A total of 32 patients with acute ischemic stroke, (16 males and 16 females) and 30 healthy controls were included in the study. Plasma MMP-9 levels were measured using ELISA method. Computed tomography was performed at 48th hour and infarct volume was calculated using the Cavalieri method. The National Institute of Health Stroke Scale (NIHSS) was checked at baseline, 12, 24, and 48th hour. Plasma MMP-9 levels of the patient group at baseline, 12, 24, and 48th hour were found significantly higher compared to the control group (p < 0.05). An important correlation between MMP-9 levels and the infarct volume was observed at baseline, 12, 24, and 48th hour (p < 0.001). Furthermore, a positive correlation was recorded between plasma MMP-9 levels and NIHSS scores at baseline, 12, 24, and 48th hour (p < 0.001). Plasma MMP-9 levels of those of suffering medium and heavy damages were found significantly higher when compared to those of having slight damage (p < 0.05). A significant relationship was also observed between infarct volumes and neurological deficits (p < 0.05). Plasma MMP-9 levels of the patients at 48th hour were found to be significantly lower in recovered patients compared to those who did not improved or worsened (p < 0.05). A positive correlation was recorded between the infarct volume and infarct progression (p < 0.05). In conclusion, this study showed that plasma MMP-9 level substantially increased during the acute period of ischemic cerebrovascular disease and correlated with the severity of the disease and infarct volume. The definition of the exact role of plasma MMP-9 after ischemic stroke will have important diagnostic implications for stroke and for the development of therapeutic strategies aimed at modulating plasma MMP-9.


Subject(s)
Brain Ischemia/blood , Brain/diagnostic imaging , Matrix Metalloproteinase 9/blood , Stroke/blood , Aged , Brain Ischemia/diagnostic imaging , Disease Progression , Female , Humans , Male , Middle Aged , Radiography , Severity of Illness Index , Stroke/diagnostic imaging
18.
Int J Neurosci ; 119(12): 2206-18, 2009.
Article in English | MEDLINE | ID: mdl-19916849

ABSTRACT

PURPOSE: Our aim was to evaluate the relationship between lesion volume, serum level of biochemical markers, and clinical situation in ischemic and hemorrhagic stroke. METHODS: MRI was obtained on 33 ischemic and 28 hemorrhagic strokes. The Cavalieri method was used to measure the volume. To evaluate neurological situation of the patients, we used the National Institutes of Health Stroke Scale (NIHSS) and Rankin Disability Scores at the first, third, seventh, and thirtieth days. We measured the level of leptin, high sensitivity C-reactive protein (hs-CRP), insulin, cortisol, fibrinogen, protein C, protein S, von Willebrand factor, D-dimer, Antitrombin III, and Factor VIII (F VIII) at the same time intervals. RESULTS: In ischemic events, cortisol level at third and seventh days, and fibrinogen level at the first day were correlated with lesion volumes (r = 0.5, p = .02; r = 0.4, p = .02; r = 0.5, p = .005, respectively). In hemorrhagic events, only fibrinogen level was correlated with lesion volumes at third day (r = 0.6, p = .04). No significant differences were found among all these biochemical parameters, neurological situation (p > .05), and lesion volumes at all times. CONCLUSION: In the prediction of stroke prognosis, lesion volume and all of the evaluated biochemical parameters are not deterministic factors.


Subject(s)
Brain Ischemia/blood , Brain Ischemia/pathology , Intracranial Hemorrhages/blood , Intracranial Hemorrhages/pathology , Stroke/blood , Stroke/pathology , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Biomarkers/metabolism , Brain/pathology , Brain Ischemia/metabolism , Disability Evaluation , Female , Fibrinogen/metabolism , Humans , Intracranial Hemorrhages/metabolism , Magnetic Resonance Imaging , Male , Middle Aged , Neuropsychological Tests , Prognosis , Stroke/metabolism , Time Factors , Young Adult
19.
Article in English | MEDLINE | ID: mdl-19646262

ABSTRACT

The purpose of this study is to evaluate prospectively the sensitivities of conventional and new electrophysiological techniques and to investigate their relationship with the body mass index (BMI) in a population of patients suspected of having carpal tunnel syndrome (CTS). In this study, 165 hands of 92 consecutive patients (81 female, 11 male) with clinical diagnosis of CTS were compared to reference population of 60 hands of 30 healthy subjects (26 female and 4 male). Extensive sensory and motor nerve conduction studies (NCSs) were performed in the diagnosis of subtle CTS patients. Also, the patients were divided into subgroups and sensitivities were determined according to BMI. The mean BMI was found to be significantly higher in the CTS than in the control group (p < 0.001). The sensitivity of the median sensory nerve latency (mSDL) and median motor distal latency (mMDL) were 75.8% and 68.5%, respectively. The most sensitive parameters of sensory and motor NCSs were the difference between median and ulnar sensory distal latencies to the fourth digit [(D4M-D4U), (77%)] and the median motor terminal latency index [(mTLI), (70.3%)], while the median-to-ulnar sensory action potential amplitude ratio (27%) and the median-thenar to ulnar-hypothenar motor action potential amplitude ratio (15%) were least sensitive tests. Sensory tests were more sensitive than motor NCSs. Combining mSDL with D4M-D4U, and mMDL with mTLI allowed for the detection of abnormalities in 150 (91%) and 132 (80%) hands, respectively. Measurements of all NCSs parameters were abnormal in obese than in non-obese patients when compared to the BMI. The newer nerve conduction techniques and combining different NCSs tests are more sensitive than single conventional NCS test for the diagnosis of suspected CTS. Meanwhile, CTS is associated with increasing BMI.

20.
Eurasian J Med ; 40(2): 79-82, 2008 Aug.
Article in English | MEDLINE | ID: mdl-25610033

ABSTRACT

OBJECTIVE: The recovery period in ischemic cerebrovascular disease is sometimes long and complicated. It is thought that a systemic inflammatory response plays an important role in this process. Therefore, promising studies have reported that neopterin and other cytokines serve as indicators of the inflammatory response. The present study investigated the effects of cerebrovascular diseases on plasma neopterin. MATERIALS AND METHODS: We studied 68 consecutive patients under 65 years of age with cerebrovascular disease; the mean age was 52.08±5.74 years (yrs) (ranging from 39 yrs to 64 yrs; 28 female and 40 male). We also studied 29 randomly selected age-matched healthy subjects (control); the mean age was 49.76±13.11 years (yrs) (ranging from 41 yrs to 62 yrs; 12 female and 17 male). Blood samples for assessing plasma levels of neopterin were usually taken within seven days after admission to the hospital and stored at -20°C until analysis. Serum neopterin levels in all the subjects were measured by Enzyme Immunoassay (EÝA) using the BRAHMS method (Neopterin; Diagnostic GmbH, 16761 Berlin, Germany). Differences between the groups' means were analyzed with the Mann-Whitney U test. RESULTS: The mean values of neopterin levels in patients (mean neopterin levels in patients, 18.51 ± 11.56 nmol/L; vs. control, 12.26 ± 3.87 nmol/L [p=.001]) were significantly different when compared with the controls. CONCLUSION: It has been suggested that the mortality and morbidity associated with cerebrovascular disease could be prevented by a reduction in the inflammatory response. We suggest that plasma neopterin levels were significantly increased. So, the levels of plasma neopterin may be useful monitoring of treatment and course of diseases.

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